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January 1965

Spontaneous Remission of Zollinger-Ellison Syndrome

Author Affiliations


From the Department of Medicine, Division of Gastroenterology, and the Department of Surgery, University of Oregon Medical School.

Arch Intern Med. 1965;115(1):42-47. doi:10.1001/archinte.1965.03860130044007

IN 1955 Zollinger and Ellison described a syndrome consisting of gastric hypersecretion and a fulminating and intractable peptic ulcer diathesis associated with islet cell tumors of the pancreas.1 Since this original description, the syndrome has been expanded to include the additional features of diarrhea,2 steatorrhea,3 and hypokalemia.4 It is now recognized that the clinical picture may be variable in its presentation with some patients developing a fulminant ulcer diathesis and others a severe diarrhea with or without peptic ulceration.2 Diarrhea occurs in one third of the patients with ulcer and is the only symptom in 10% of the recorded cases.5 The pathogenesis of the basal gastric hypersecretion is postulated to be parietal cell stimulation by a gastrin-like substance elaborated in nonbeta islet tumor cells of the pancreas. A substance, capable of stimulating gastric secretion in pouch preparations, has been isolated from both primary tumors and metastatic tissue.5,6 The assault of