The secretin provocation test for gastrinoma is based on the premise that secretin decreases or has no effect on serum gastrin in normal and duodenal ulcer subjects while inducing a paradoxical rise in gastrinoma. We reexamined the serum gastrin response to pharmacologic amounts of secretin in normal volunteers (N=17) and unoperated duodenal ulcer patients (N=10). GIH secretin caused significant early gastrin rises from baseline in both groups (P<0.05). The gastrin response curves after secretin were not significantly different between normal and ulcer subjects. Similar gastrin rises were seen when synthetic secretin was administered to normal subjects (N=6). In normal volunteers, intravenous bolus saline (N=10) or amino acid (l-cysteine, N=8) caused no change in serum gastrin from baseline. The gastrin response curves to GIH secretin and saline were significantly different (P<0.05). Our findings suggest that the gastrin rise in gastrinoma patients after secretin is an exaggeration of the normal response and not paradoxical.
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