Twenty-three patients with
hyperparathyroidism from six families with the
multiple endocrine adenomatosis (MEA) I-syndrome were tested by
secretin provocation. In nine cases this led to increases in serum
gastrin ranging from 298 to 13 300 pg/ml, whereas the maximum rise in
gastrin in the other 14 patients was 32 pg/ml. In all nine patients with marked
gastrin responses to
secretin, the
Zollinger-Ellison syndrome was diagnosed by gastric acid hypersecretion and large increases in
gastrin after
calcium administration. Six of these nine patients had, at most, minor postprandial rises in gastin and two had demonstrable
tumors. In 34 normal subjects, 23 nonaffected members of families with MEA I-syndrome, and 42 patients with various diseases the maximum
gastrin response to
secretin was 21 pg/ml. We conclude that
secretin provocation is helpful in the diagnosis of the
Zollinger-Ellison syndrome, especially when basal serum
gastrin levels are only slightly elevated.