Figure 3.
Effect of curative gastrinoma resection on basal acid hypersecretion(BAO) (Panel A) and effect of parathroidectomy (Panel B) on basal acid hypersecretion, fasting serum gastrin levels and responsiveness to antisecretory drugs in MEN1/ZES patients with hyperparathyroidism.
Panel A. Shown are results from 20 patients surgically rendered disease-free. Mean preoperative BAO was 39 mEq/hr, and the mean serum fasting gastrin 1020 pg/ml (nl<100). By 3–6 mos. postoperatively BAO had decreased 75% and remained unchanged. Dotted lines show upper limit of normal in these studies.
Adapted from Pisegna JR, Norton JA, Slimak G, et al. Effects of curative resection on gastric secretory function and antisecretory drug requirement in the Zollinger-Ellison syndrome. Gastroenterology 1992;102:767–778; with permission.
Panel B. Shown are results from 10 consecutive MEN1/ZES patients with hyperparathyroidism with basal acid output, fasting serum gastrin levels(FSG), and sensitivity to antisecretory drugs (Histamine H2 receptor antagonists [], determined before and a different times post parathyroidectomy. All patients except patient 4 became normocalcemic post parathyroidectomy. Post parathyroidectomy 9/10 (90%) had a decrease in BAO, and 7/10 showed a decrease in FSG including to normal levels in 2 patients. Acid responsiveness was expressed as the percent of the BAO at a given time after taking the same dose of histamine H2 receptor antagonist. In each of the three patients studied the given dose of histamine H2 receptor antagonist caused greater acid suppression post parathyroidectomy.
Adapted from Norton JA, Cornelius MJ, Doppman JL et al. Effect of parathyroidectomy in patients with hyperparathyroidism, Zollinger-Ellison syndrome and multiple endocrine neoplasia Type I: A prospective study. Surgery 1987;102:958–966; with permission.