Clinical outcome using lansoprazole in acid hypersecretors with and without Zollinger-Ellison syndrome: A 13-year prospective study

Chromogranin A in patients with acid hypersecretion and/or hypergastrinaemia

“…15,16 ZE and non-ZE patients had similar high acid output and clinical manifestations of peptic ulcers, and oesophagitis, with a similar incidence of complications. 14,15 All were treated with the PPI lansoprazole, individually optimized to reduce BAO to a range of 0-5 mmol ⁄ h. 15 In actual practice, BAO was reduced more than 90% from pre-treatment values to a mean of 1.9 AE 0.2 mmol ⁄ h. 14 In this study, CgA was first measured after a median of 5 years (range: 0.25-12) of lansoprazole treatment, and again 2.5 years later in 42 of the 51 hypersecretors. In addition, we studied 12 patients with autoimmune atrophic gastritis and PA, originally referred to us to rule out ZE because of hypergastrinaemia.…”

“…[14][15][16] Multiple Endocrine Neoplasia-1 (MEN-1) was documented in four of the 38 ZE patients. Patients were followed up for up to 15 years, in a long-term prospective IRB-approved protocol.…”

“…[17][18][19] To sort out these possibly confounding alternate sources of increased circulating CgA, we studied CgA, gastrin and ECL cells in patients with gastric acid hypersecretion with gastrinoma (ZE) and without (non-ZE), who were undergoing prolonged continuous treatment in the same protocol using the PPI lansoprazole. [14][15][16] The non-ZE acid hypersecretors, who have minimal or no gastrin elevation and no ECL cell proliferation, 16 were studied specifically for possible effects of the PPI-related acid suppression on CgA. A third group, patients with autoimmune atrophic gastritis (pernicious anaemia, PA) were also studied because they have prominent ECL cell proliferation including carcinoids 20,21 due to marked hypergastrinaemia induced by total achlorhydria, but have neither gastrinoma nor any possible direct PPI effect.…”

Medical Management of Acid-Peptic Disorders of the Stomach

“…Before the advent of PPIs, medical therapy had little to offer in either the short-term management of the preoperative patient or in the long-term management of inoperable patients. With omeprazole and its related successors, acid secretion can now be effectively controlled in these patients for long periods of time if necessary [15][16][17][18]. Intravenous administration of PPIs is also efficacious in the perioperative patient [19].…”

Prospective Evaluation of Quality of Life in Patients with Zollinger–Ellison Syndrome

“…Even in selected patient populations at expert centers, cure rates are only approximately 50% [5]. Patient survival is typically excellent, even with tumor burden; many patients survive for more than 25 years [6]. Subjectively, untreated ZES has a dramatic effect on the patients' quality of life.…”