Zollinger-Ellison syndrome: presentation, response to therapy, and outcome.

Abstract

BACKGROUND:

Recent series describing the clinical presentation, response to therapy, and long-term outcome of Zollinger-Ellison syndrome are limited.

AIMS:

To assess the clinical characteristics and long-term outcome of patients with Zollinger-Ellison syndrome.

METHODS:

Over a 20-year period, patients with Zollinger-Ellison syndrome were enrolled in a prospective trial evaluating the efficacy of lansoprazole. Following dose stabilization, patients were followed on a 6-monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis and laboratory studies.

RESULTS:

72 patients (mean age 54±12 years, % male 58%, % Caucasian 69%) were prospectively enrolled. The clinical presentation was stereotypical for Zollinger-Ellison syndrome. Symptoms had been reported for a median of 9 years prior to diagnosis. Cross-sectional abdominal imaging was often negative for demonstrable tumour. All patients had gastric acid hypersecretion controlled with variable doses of lansoprazole (median dose 60 mg/day, range 15-480 mg/day). The median survival from the time of diagnosis was 6.6 years; only two of 19 deaths were due to metastatic gastrinoma.

CONCLUSIONS:

The clinical presentation of Zollinger-Ellison syndrome was similar to prior reports. Acid hypersecretion was controlled in all patients with variable doses of lansoprazole. Long-term survival was principally related to underlying co-morbidity.

• Authors: C Mel Wilcox, Toni Seay, Justin T Arcury, Jean Mohnen, Basil I Hirschowitz
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 43 Issue 6 Pg. 439-43 (Jun 2011) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 21193359 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Ulcer Agents
• Lansoprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles (administration & dosage, therapeutic use)
• Adult
• Aged
• Aged, 80 and over
• Anti-Ulcer Agents (administration & dosage, therapeutic use)
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Lansoprazole
• Male
• Middle Aged
• Prospective Studies
• Treatment Outcome
• Zollinger-Ellison Syndrome (diagnosis, drug therapy, mortality)