PMID- 35919366
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220805
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 6
DP  - 2022 Jun
TI  - Zollinger Ellison Syndrome Refractory to Medical Therapy in the Setting of 
      Multiple Endocrine Neoplasia Type I.
PG  - e26468
LID - 10.7759/cureus.26468 [doi]
LID - e26468
AB  - Multiple Endocrine Neoplasia 1 (MEN1) syndrome is a genetic condition arising 
      from a mutation of the MEN1 gene resulting in neuroendocrine tumor formation. 
      Patients with MEN1 are at a higher risk of developing Zollinger-Ellison syndrome 
      (ZES) due to the growth of neuroendocrine tumors called gastrinomas that release 
      gastrin leading to hypersecretion of acid in the stomach resulting in severe 
      ulcerative disease of the upper GI tract. Our case is a 42-year-old female with 
      newly diagnosed MEN1 syndrome, presenting with acute abdominal pain and dyspepsia 
      refractory to medical management including proton pump inhibitors (PPI) and H2 
      antagonists. ZES was biochemically confirmed with a secretin stimulation test and 
      dotatate positron emission tomography/computed tomography (PET/CT) revealed 
      multiple areas of hyper-metabolic activity within the gastrinoma triangle. 
      However, no discrete masses could be appreciated on endoscopic ultrasound (EUS) 
      or CT imaging that could provide a target for surgical intervention. This case 
      elucidates not only the difficulty of gastrinoma localization in medically 
      refractory ZES but also reinforces the need to screen patients with MEN1 
      presenting with acute abdominal pain and dyspepsia for ZES.
CI  - Copyright (c) 2022, Martino et al.
FAU - Martino, Brendan R
AU  - Martino BR
AD  - Internal Medicine, Tripler Army Medical Center, Honolulu, USA.
FAU - Manibusan, Pedro
AU  - Manibusan P
AD  - Gastroenterology, Tripler Army Medical Center, Honolulu, USA.
LA  - eng
PT  - Case Reports
DEP - 20220630
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9338823
OTO - NOTNLM
OT  - endoscopic ultrasound (eus)
OT  - esophagogastroduodenoscopy (egd)
OT  - gastrinoma
OT  - multiple endocrine neoplasia type 1 (men1)
OT  - zollinger-ellison syndrome
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/08/04 06:00
MHDA- 2022/08/04 06:01
PMCR- 2022/06/30
CRDT- 2022/08/03 02:07
PHST- 2022/06/30 00:00 [accepted]
PHST- 2022/08/03 02:07 [entrez]
PHST- 2022/08/04 06:00 [pubmed]
PHST- 2022/08/04 06:01 [medline]
PHST- 2022/06/30 00:00 [pmc-release]
AID - 10.7759/cureus.26468 [doi]
PST - epublish
SO  - Cureus. 2022 Jun 30;14(6):e26468. doi: 10.7759/cureus.26468. eCollection 2022 
      Jun.