Zollinger-Ellison syndrome is best screened by which test?

Zollinger-Ellison syndrome is best screened by which test?

• A. Gastrin-secreting tumor (gastrinoma) in the pancreas or duodenum
• B. Adrenal tumor
• C. Pituitary tumor
• D. Thyroid tumor

Answer: (A)

Zollinger-Ellison syndrome is driven by a gastrin-secreting tumor, typically in the pancreas or duodenum, which causes excessive gastric acid production and peptic ulcers. Because the underlying issue is hypergastrinemia from a gastrinoma, the best screening approach is to measure the fasting serum gastrin concentration. A very high gastrin level strongly points to a gastrinoma; if results are borderline, a secretin stimulation test can help confirm, but the initial screen hinges on detecting elevated gastrin. The other tumors listed (adrenal, pituitary, thyroid) do not cause this hypergastrinemia or acid overproduction, so they aren’t candidates for screening ZES.

Zollinger-Ellison syndrome is driven by a gastrin-secreting tumor, typically in the pancreas or duodenum, which causes excessive gastric acid production and peptic ulcers. Because the underlying issue is hypergastrinemia from a gastrinoma, the best screening approach is to measure the fasting serum gastrin concentration. A very high gastrin level strongly points to a gastrinoma; if results are borderline, a secretin stimulation test can help confirm, but the initial screen hinges on detecting elevated gastrin. The other tumors listed (adrenal, pituitary, thyroid) do not cause this hypergastrinemia or acid overproduction, so they aren’t candidates for screening ZES.