5-Minute Clinical Consult

Zollinger-Ellison Syndrome

Zollinger-Ellison Syndrome was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.

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Basics

Description

  • Zollinger-Ellison Syndrome triad:
    • Markedly elevated gastric acid secretion
    • Peptic ulcer disease
    • A gastrinoma or non-β islet cell tumor of the pancreas or duodenal wall that produces gastrin
  • Gastrinomas (at the time of diagnosis) may be single or multiple (1/2–2/3), large or small, benign or malignant (2/3), sporadic (70–75%) or associated with MEN1 (multiple endocrine neoplasia type 1) (25–30%).
  • System(s) affected: Endocrine/Metabolic; Gastrointestinal
  • Synonym(s): Z-E syndrome; Pancreatic ulcerogenic tumor syndrome; Multiple endocrine neoplasia, partial; Ulcerogenic islet cell tumor

Epidemiology


Incidence
  • 1–3 per million per year
  • Predominant age: Middle age (30–65 years)
  • Predominant sex: Male > Female (1.3:1)

Pediatric Considerations
Very aggressive cases have been reported in teenagers.

Pregnancy Considerations
Cases reported; influences medication choices and surgical timing

Risk Factors

  • MEN1
  • Family history of ulcer disease

Genetics
~25–30% of cases occur in association with the MEN1 syndrome.

General Prevention

Screen 1st-degree relatives of patients with MEN1.

Etiology

  • Gastrinoma is equally distributed between the head of the pancreas and the 1st or 2nd portion of the duodenum; if in the pancreas, the lesion is more likely to metastasize to the liver.
  • Also may be found rarely in the mesentery, peritoneum, spleen, skin, or mediastinum (possibly metastasis with primary not identified)

Commonly Associated Conditions

  • MEN1: Hyperparathyroidism, prolactinomas, other pituitary tumors
  • Insulinoma
  • Carcinoid tumors

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