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. Author manuscript; available in PMC: 2019 Sep 3.
Published in final edited form as: Ann Intern Med. 1993 Aug 1;119(3):199–206. doi: 10.7326/0003-4819-119-3-199308010-00004

Figure 4. Changes over time in fasting serum gastrin level, secretin provocative test results, and imaging studies in two patients who developed recurrent disease. Top Panel.

Figure 4

The time course of changes in this patient is typical of the 45% of patients in whom recurrence was detected initially by a positive secretin provocative test alone and who only later developed elevated fasting serum gastrin levels in association with either positive (9%) (as shown in this patient) or negative (36%) imaging studies. Bottom Panel. The time course of changes in this patient is typical of the 18% of patients who developed both an abnormal fasting serum gastrin level and secretin provocative test as the first sign of recurrence and in whom imaging studies continued to be normal. Dotted lines represent the upper limits of normal for the fasting serum gastrin level and secretin provocative test.