Plasma gastrin measurement cannot be used to diagnose a gastrinoma in patients on either proton pump inhibitors or histamine type-2 receptor antagonists.

Abstract

BACKGROUND:

Patients with a gastrinoma are treated with proton pump inhibitors (PPI) and histamine type-2 receptor antagonists (H2). In order to diagnose a gastrinoma these drugs must be discontinued, but this increases the risk of gastrointestinal perforation. We aimed to determine if a gastrinoma could be diagnosed without cessation of PPI/H2 therapy.

METHODS:

In all, 90 patients (controls and patients diagnosed with a gastrinoma both on and off PPI/H2 therapy) were recruited, and plasma gastrin measured.

RESULTS:

Patients with a gastrinoma on PPI/H2 medication had a significantly higher fasting plasma gastrin concentration than control patients on PPI/H2 medication (298+/-33 versus 204+/-30 pmol/L, P = 0.01). However, there was substantial overlap between gastrin levels in these two groups.

CONCLUSION:

This study confirms that a gastrinoma cannot be diagnosed on the basis of a fasting plasma gastrin assay while patients remain on PPI/H2 therapy.

• Authors: W S Dhillo, C N Jayasena, C J Lewis, N M Martin, K C N Tang, K Meeran, J F Todd
• Journal: Annals of clinical biochemistry (Ann Clin Biochem) Vol. 43 Issue Pt 2 Pg. 153-5 (Mar 2006) ISSN: 0004-5632 [Print] England
• PMID: 16536918 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Gastrins
• Histamine H2 Antagonists
• Proton Pump Inhibitors

Topics

• Aged
• Female
• Gastrinoma (diagnosis, drug therapy)
• Gastrins (blood)
• Histamine H2 Antagonists (administration & dosage, therapeutic use)
• Humans
• Male
• Middle Aged
• Pancreatic Neoplasms (diagnosis, drug therapy)
• Proton Pump Inhibitors