Weight Gain in Zollinger-Ellison Syndrome After Acid Suppression.

OBJECTIVES: Zollinger-Ellison syndrome (ZES) is characterized by hypergastrinemia and gastric acid hypersecretion resulting in peptic ulcer disease, diarrhea, and weight loss. Acid secretion can be controlled with medication, and biochemical cure is possible with surgery. Data on how these interventions affect patients' weight are lacking. We aimed to determine how medical and surgical acid control affects weight over time. METHODS: We performed a retrospective cohort study on 60 ZES patients. Acid control was achieved with appropriate-dose proton pump inhibitor (PPI) therapy. Surgery was performed for curative intent when appropriate. Weight change was assessed versus pre-acid control or immediate preoperative weights and expressed as absolute and percent change from baseline at 6, 12, 18, and 24 months. RESULTS: A total of 30 PPI-controlled patients and 20 surgery-controlled patients were analyzed. Weight gain was noted at all time points while on appropriate-dose PPI therapy (P < 0.005). Of patients who had surgery with curative intent, weight gain was noted at 12 months (7.9%, P = 0.013) and 18 months (7.1%, P = 0.007). There was a trend toward weight gain seen at all time points in the patients who were surgically cured. CONCLUSIONS: These data represent a novel description of weight gain after acid suppression in ZES.

Sindrome de Zollinger-Ellison: uma revisao / Zollinger-Ellison syndrome: review article

Apesar de sua raridade, a Sindrome de Zollinger-Ellison (SZE) foi alvo de intensos estudos, os quais contribuiram para a construcao da moderna endocrinologia gastrointestinal. Tradicionalmente, as estrategias diagnosticas e terapeuticas voltaram-se apenas ao controle da hipersecrecao gastrica, obtido geralmente atraves da gastrectomia total. Entretanto, com o desenvolvimento de drogas eficazes na inibicao da secrecao gastrica, as atencoes tem se voltado as possibilidades de resseccao cirurgica e cura do processo neoplasico. A localizacao do tumor (atraves de estudos bioquimicos, radiologicos e endoscopicos) e uma etapa essencial para o...

Síndrome de Zöllinger-Ellison / Zöllinger-Ellison's syndrome

Se presenta un caso de síndrome de Zöllinger-Ellison careacterizado por alta agresividad de la enfermedad ulcerosa péptica, marcada tendencia a la producción de fístulas, escasa respuesta a los bloqueadores H2 y difícil manejo quirúrgico. Se efectúa un análisis crítico del caso clínico y su manejo médico-quirúrgico a la luz de la información que existe actualmente sobre esta entidad

Síndrome de Zollinger-Ellison: revisäo / Zollinger-Ellison syndrome: review

O objetivo deste trabalho é de uma revisäo da literatura sobre aspectos de incidência, fisiopatologia, apresentaçäo clínica e recentes avanços na avaliaçäo diagnóstica e manejo terapêutico. Especial atençäo terapêutica medicamentosa com antogonistas de receptor H3 da histamina

Ulceras pépticas posoperatorias recurrentes: correlación clínicas, biológica e histológica en los antros retenidos / Peptic ulcers postoperative recurrent: correlation clinic, biology and histologic in the cavern reteing

Se presentan los resultados quirúrgicos obtenidos en 20 pacientes con úlceras pépticas posoperatorias recidivantes originadas por insuficientes conductas operatorias previas. Se establecen los fundamentos fisiológicos de las operaciones correctoras analizando especialmente la correlación clínica, biológica e histopátológica en los antros retenidos. Con técnicas inmunohistológicas se estudia la relación celular G/D alterada por el pH luminal y reponsable de la recurrencia ulcerosa en un paciente con antro retenido señalando las discretas gastrinemias que se registran en todos estos enfermos

Ulceras pépticas posoperatorias recurrentes: correlación clínicas, biológica e histológica en los antros retenidos / Peptic ulcers postoperative recurrent: correlation clinic, biology and histologic in the cavern reteing

Se presentan los resultados quirúrgicos obtenidos en 20 pacientes con úlceras pépticas posoperatorias recidivantes originadas por insuficientes conductas operatorias previas. Se establecen los fundamentos fisiológicos de las operaciones correctoras analizando especialmente la correlación clínica, biológica e histopátológica en los antros retenidos. Con técnicas inmunohistológicas se estudia la relación celular G/D alterada por el pH luminal y reponsable de la recurrencia ulcerosa en un paciente con antro retenido señalando las discretas gastrinemias que se registran en todos estos enfermos (AU)

[Is basal hypersecretion an indication of the presence of Zollinger-Ellison syndrome?]. / Es la hipersecreción basal sugerente de la existencia de un sindrome de Zollinger-Ellison?

Twenty patients with gastric basal hipersecretion over 15 mEq/hr and a suspicion on a Z-E syndrome or gastrinoma were studied by means of histamin gastric analisis, calcium test and measurement of lower esophageal sphincter pressures. In none of them a pancreatic tumour was found at operation, being their post-operative course normal up to a 60 months follow-up. The use of these everyday techniques is proposed for medical centers which have no facilities for gastrin radioimmunoassay techniques.