Sporadic
MEN1( 20%)
Clinical features:
Affects age group 20-50
Symptoms:
Reflux, dyspepsia, abdomen pain, diarrhea, recurrent peptic ulcer disease with many ulcers and ulcers distal to duodenum and jejunum.
Endoscopy:
Thickened gastric folds and multiple ulcers
Lab:
Fasting serum gastrin level ( >1000 pg/ml diagnostic, < 100 rules out gastrinoma)
Next check gastric pH ( to rule out achlorhydria)
Secretin stimulation test( gastrin 100-1000): Increase in gastrin level is diagnostic( normal gastric cells inhibited by secretin).
