A STUDY OF SECRETIN DOSAGE OF SECRETIN PROVOCATION TEST IN THE ZOLLINGER-ELLISON SYNDROME

Abstract

The present study was undertaken to examine the minimal dose of secretin in secretin provocation test to diagnose Zollinger-Ellison syndrome (ZES). Two different dosage (3 units/kg•weight and 6 units/kg•weight) secretin provocation tests were performed in 4 patients with ZES and 20 patients with ordinary peptic ulcer disease (non-ZES). Secretin provocation tests by drip infusion and bolus injection were performed in 2 patients with ZES. Single dosage secretin provocation tests were performed in other two patients with ZES.
In non-ZES patients serum gastrin levels increased as much by 3 units/kg secretin as by 6 units/kg secretin. Six units/kg secretin injection raised serum gastrin significantly in 4 cases with ZES whereas 3 units/kg secretin injection didn't raise it significantly in 3 of 4 case with ZES. Bolus injection of secretin raised serum gastrin levels higher than drip infusion of secretin. Other two ZES patients had positive secretin test by 3 units/kg or 6 units/kg secretin injection.
These studies indicates that secretin provocation tests should be done with the dosage of 6 units/kg by bolus injection. In ZES patients serum ionized calcium levels increased so little after secretin injection that direct relation between serum gastrin and serum ionized calcium could not be determined.