PMID- 16249283
OWN - NLM
STAT- MEDLINE
DCOM- 20060131
LR  - 20120910
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 91
IP  - 1
DP  - 2006 Jan
TI  - Patients with multiple endocrine neoplasia type 1 with gastrinomas have an 
      increased risk of severe esophageal disease including stricture and the 
      premalignant condition, Barrett's esophagus.
PG  - 204-12
AB  - CONTEXT: Multiple endocrine neoplasia type 1 (MEN1) patients frequently develop 
      Zollinger-Ellison syndrome (MEN1/ZES). Although esophageal reflux symptoms are 
      common in these patients, little is known about long-term occurrence of severe 
      peptic esophageal disease including strictures and Barrett's esophagus (BE). 
      OBJECTIVE: The objective of the study was to prospectively analyze the frequency 
      of severe peptic esophageal disease in ZES patients with and without MEN1. 
      SETTING: The study was conducted at a tertiary care research center. PATIENTS: 
      Two hundred ninety-five patients (80 = MEN1/ZES, 215 = sporadic ZES) participated 
      in a prospective study. INTERVENTIONS AND OUTCOME MEASURES: Assessment of MEN1, 
      acid hypersecretion, upper gastrointestinal endoscopy/biopsies, and tumor status 
      were measured initially and at each follow-up. Esophageal manometry was performed 
      in 89 patients. Frequency and type of esophageal disease were correlated with 
      clinical/laboratory/tumoral features of ZES/MEN1. RESULTS: In MEN1/ZES patients, 
      esophageal stricture was 3-fold higher, BE 5-fold higher, and dysplasia 8-fold 
      higher, and one patient died of esophageal adenocarcinoma. Esophageal symptoms 
      were more frequent or severe in MEN1/ZES, but known risk factors for severe 
      esophageal disease and ZES-specific features did not differ between MEN1/ZES and 
      sporadic ZES. In MEN1/ZES, the onset of ZES was 10 yr earlier, and H2-antagonists 
      were used longer and at lower doses. MEN1/ZES patients with esophageal disease 
      differed from those without in that ZES diagnosis was delayed longer, esophageal 
      symptoms were more frequent or severe, hiatal hernias were more frequent, 
      esophagitis or pyloric scarring was more common, basal acid output was higher, 
      and hyperparathyroidism was underdiagnosed. CONCLUSIONS: This study shows that 
      MEN1/ZES patients have a higher incidence of severe esophageal disease including 
      the premalignant condition BE and identifies factors important for their 
      pathogenesis that need to be incorporated into their long-term treatment.
FAU - Hoffmann, K Martin
AU  - Hoffmann KM
AD  - Digestive National Institutes of Health/National Institute of Diabetes and 
      Digestive and Kidney Diseases/Digestive Diseases Branch, Bethesda, Maryland 
      20892-1804, USA.
FAU - Gibril, Fathia
AU  - Gibril F
FAU - Entsuah, Laurence K
AU  - Entsuah LK
FAU - Serrano, Jose
AU  - Serrano J
FAU - Jensen, Robert T
AU  - Jensen RT
LA  - eng
PT  - Journal Article
DEP - 20051025
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Histamine H2 Antagonists)
SB  - IM
MH  - Adult
MH  - Barrett Esophagus/*epidemiology/*etiology
MH  - Esophageal Diseases/*epidemiology/*etiology
MH  - Esophageal Sphincter, Lower/physiopathology
MH  - Esophageal Stenosis/*epidemiology/*etiology
MH  - Esophagoscopy
MH  - Female
MH  - Gastric Acidity Determination
MH  - Gastrinoma/*complications
MH  - Histamine H2 Antagonists/pharmacology
MH  - Humans
MH  - Male
MH  - Multiple Endocrine Neoplasia Type 1/*complications
MH  - Prospective Studies
MH  - Risk
MH  - Sex Factors
MH  - Zollinger-Ellison Syndrome/complications
EDAT- 2005/10/27 09:00
MHDA- 2006/02/01 09:00
CRDT- 2005/10/27 09:00
PHST- 2005/10/27 09:00 [pubmed]
PHST- 2006/02/01 09:00 [medline]
PHST- 2005/10/27 09:00 [entrez]
AID - jc.2005-1349 [pii]
AID - 10.1210/jc.2005-1349 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2006 Jan;91(1):204-12. doi: 10.1210/jc.2005-1349. Epub 
      2005 Oct 25.