The diagnostic test for Z-E syndrome is
Zollinger-Ellison syndrome may be suspected when the above symptoms prove resistant to treatment, when the symptoms are especially suggestive of the syndrome, or when endoscopy is suggestive. The diagnosis is made through several laboratory tests and imaging studies: Secretin stimulation test, which measures evoked gastrin levels. Note that the mechanism underlying this test is in contrast to the normal physiologic mechanism whereby secretin inhibits gastrin release from G cells. Gastrinoma cells release gastrin in response to secretin stimulation, thereby providing a sensitive means of differentiation. Fasting gastrin levels on at least three separate occasions Gastric acid secretion and pH (normal basal gastric acid secretion is less than 10 mEq/hour; in Zollinger-Ellison patients, it is usually more than 15 mEq/hour) An increased level of chromogranin A is a common marker of neuroendocrine tumors. In addition, the source of the increased gastrin production must be determined using MRI or somatostatin receptor scintigraphy Ref Harrison20th edition pg 1336
Secretin test
Standard test meal
ACTH Infusion
Ca infusion
Infection