2009
DOI: 10.1007/s12253-009-9192-7
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PPI-Delayed Diagnosis of Gastrinoma: Oncologic Victim of Pharmacologic Success

Abstract: Functional neuroendocrine tumors are often low-grade malignant neoplasms that can be cured by surgery if detected early, and such detection may in turn be accelerated by the recognition of neuropeptide hypersecretion syndromes. Uniquely, however, relief of peptic symptoms induced by hypergastrinemia is now available from acid-suppressive drugs such as proton-pump inhibitors (PPIs). Here we describe a clinical case in which time to diagnosis from the onset of peptic symptoms was delayed more than 10 years, in p… Show more

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Cited by 14 publications
(11 citation statements)
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References 23 publications
(32 reference statements)
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“…Accurate GAO analysis is seldom used because of perceived obsolescence, patient intolerance, cost, lack of expertise and inaccuracy. Where still performed, GAO is helpful in the diagnosis and management of rare hypersecretory states, which can sometimes be missed due to PPI masking . If a method of GAO analysis were developed that was non‐invasive, easily administered, accurate and reproducible, it is likely that its use would become more widespread for application in refractory GERD, acid hypersecretory states, antisecretory drug development, atrophic gastritis and gastric cancer screening .…”
Section: Discussionmentioning
confidence: 99%
“…Accurate GAO analysis is seldom used because of perceived obsolescence, patient intolerance, cost, lack of expertise and inaccuracy. Where still performed, GAO is helpful in the diagnosis and management of rare hypersecretory states, which can sometimes be missed due to PPI masking . If a method of GAO analysis were developed that was non‐invasive, easily administered, accurate and reproducible, it is likely that its use would become more widespread for application in refractory GERD, acid hypersecretory states, antisecretory drug development, atrophic gastritis and gastric cancer screening .…”
Section: Discussionmentioning
confidence: 99%
“…27%) in MEN-1 gastrinomas patients [14]. The widespread use of proton-pump inhibitors may mask the classical symptoms of Zollinger-Ellison syndrome and delay the diagnosis of a gastrinoma [15]. Associated nephrolithiasis [7] occurs more often in MEN-1 patients and cutaneous lesions (angiofibromas and collagenomas) have a sensitivity of 75% and specificity of 95% to predict the presence of MEN-1 in patients with Zollinger-Ellison syndrome [16].…”
Section: Clinical Presentationmentioning
confidence: 99%
“…Unfortunately, the widespread use of PPIs and histamine 2 blockers masks symptoms of ZES so that the diagnosis is delayed and further complications arise. 4,8 Chronic PPI treatment may also cause disease progression in ZES. 9 Our patient was taking antacids and PPIs, but his symptoms persisted even after surgery.…”
Section: Discussionmentioning
confidence: 99%