Zollinger-Ellison syndrome: Sensitivity and Specificity

Introduction: Zollinger-Ellison syndrome is the entity of a gastrin-secreting tumor causing peptic ulcers (and often diarrhea). It occurs in patients with MEN1.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Endocrine Gastrointestinal Problem Tag this Diagnosis.

The sensitivity and specificity of findings for Zollinger-Ellison syndrome are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Secretin Stimulation Test
Duplicate

94%

100%

gastrin rise > 120 pg/ml (in normal patients, secretin should inhibit gastrin production)

Sensitivity is only 83% if cutoff is >200pg/ml rise.

Study: Medicine (Baltimore). 2006 Nov;85(6):331-64. PMID 17108779

Secretin Stimulation Test
Duplicate

86%

93%

gastrin rise > 50% over baseline

Study: Medicine (Baltimore). 2006 Nov;85(6):331-64. PMID 17108779

Specific Findings

Calcium Infusion Study
Duplicate

58%

100%

rise in gastrin >= 395 pg/ml

The test is performed by infusing calcium gluconate (5 mg/kg body weight per hour for three hours) and determining serum gastrin levels every 30 minutes.

Study: Medicine (Baltimore). 2006 Nov;85(6):331-64. PMID 17108779

Sensitive Findings

Elevated Fasting Serum Gastrin

Sensitivity = 97%

above upper limit of normal. No specificity mentioned but 2/3 of patients have elevated fasting gastrin < 10x upper limit, which overlaps with H pylori or G cell hyperplasia.

Also must ensure that gastric pH is normal for this test to be valid.

Study: Medicine (Baltimore). 2006 Nov;85(6):295-330. PMID 17108778

Poorly Diagnostic Findings

Calcium Infusion Study
Duplicate

78%

83%

gastrin rise >= 50% above baseline

Study: Medicine (Baltimore). 2006 Nov;85(6):331-64. PMID 17108779