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Good Positive and Negative Likelihood Ratios

Poorly Diagnostic Findings

Zollinger-Ellison syndrome: Likelihood Ratios

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

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Tags: Endocrine Gastrointestinal Problem Tag this Diagnosis.

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

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
Secretin Stimulation Test
Duplicate Edit
inf0.1

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 Edit
12.30.2

gastrin rise > 50% over baseline

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

Calcium Infusion Study
Duplicate Edit
4.60.3

gastrin rise >= 50% above baseline

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

Calcium Infusion Study
Duplicate Edit
inf0.4

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

Poorly Diagnostic Findings

Finding +LR-LR Comments, Study
Elevated Fasting Serum Gastrin Edit 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