RT Book, Section A1 Lew, Edward A2 Greenberger, Norton J. A2 Blumberg, Richard S. A2 Burakoff, Robert SR Print(0) ID 1119987109 T1 Zollinger-Ellison Syndrome (Gastrinoma) T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071837729 LK accessmedicine.mhmedical.com/content.aspx?aid=1119987109 RD 2024/03/29 AB ESSENTIALS OF DIAGNOSISPeptic ulcer disease, abdominal pain, and diarrhea are common presentations.Patients have marked gastric acid secretion arising from a gastrin-secreting non–β islet cell tumor.Multiple endocrine neoplasia syndrome type 1 (MEN 1) is present in approximately 20–25% of patients.Serum gastrin concentration >1000 pg/mL in combination with acidic stomach pH <2.0 is diagnostic.Up to 40% of patients have elevated serum gastrin levels that are <500 pg/mL and warrant a secretin test.Significant hypergastrinemia can occur with proton pump inhibitor (PPI) use, Helicobacter pylori infection, or chronic atrophic gastritis and hypochlorhydria.