Secretin stimulation test

Purpose

To diagnose gastrinoma (Zollinger-Ellison syndrome).

Preparation

Subject should be fasting on the day of study. Acid suppressive medications should be discontinued well in advance to avoid effects on gastrin release.*

Method

Baseline blood samples are taken five minutes and immediately prior to (time -5 minutes and 0 minutes) secretin administration. Secretin (0.4 mcg/kg) is given IV over a one minute period. Serum samples are taken at two, five, 10, and 30 minutes after injection.

Contraindications

Secretin testing should not be performed in patients with acute pancreatitis.

Interpretation

Baseline serum gastrin in patients with gastrinoma is greater than 150 pg/mL. A positive secretin stimulation test demonstrates a quick and substantial increase in serum gastrin (by more than 120 pg/mL) has a sensitivity and a specificity for gastrinoma of 94 and 100 percent, respectively.

Note

Achlorhydria or profound hypochlorhydria can result in increased fasting serum gastrin levels and an exaggerated response to IV secretin stimulation. Proton pump inhibiting medications should be discontinued one week before the test and patients placed on a H2 receptor antagonist, which should be discontinued 24 hours prior to testing.

*Some authorities recommend that proton pump inhibitors should not be discontinued because of the risk that patients with severe disease may develop acute complications such as bleeding and perforation (see text).

Graphic 64937 Version 3.0

خرید پکیج

Secretin stimulation test