Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy

Basil I. Hirschowitz, James Griffith, David Pellegrin, Oscar Cummings

Research output: Contribution to journalArticle

169 Citations (Scopus)

Abstract

In rats, hypergastrinemia due to achlorhydria produced by antisecretory drugs or resection of the gastric fundus leads to enterochromaffinlike (ECL) cell hyperplasia and gastric carcinoids. In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastric carcinoids in as many as 5% of cases. To examine the apparent gastrin dependence of gastric ECL carcinoids, three patients were studied (2 men aged 59 and 73 years; 1 woman aged 45 years) who had pernicious anemia, serum gastrin concentrations of >1000 ng/L (>1000 pg/mL), and multicentric gastric carcinoids. Antrectomy resulted in normalization of serum gastrin levels within 8 hours and disappearance of carcinoids in 6-16 weeks. In each of the three patients, a focus of microcarcinoid was found at 12-18 months. Further follow-up in each of the three patients 21-30 months after antrectomy again showed no carcinoids or ECL cell hyperplasia. It is concluded that multicentric ECL gastric carcinoids in patients with pernicious anemia and achlorhydria appear to be gastrin dependent and disappear after normalization of serum gastrin by antrectomy. Antrectomy rather than total gastrectomy may be the most appropriate treatment for this condition.

Original languageEnglish (US)
Pages (from-to)1409-1418
Number of pages10
JournalGastroenterology
Volume102
Issue number4 PART 1
StatePublished - 1992
Externally publishedYes

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Pernicious Anemia
Carcinoid Tumor
Stomach
Gastrins
Achlorhydria
Hyperplasia
Serum
Gastric Fundus
Gastrectomy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy. / Hirschowitz, Basil I.; Griffith, James; Pellegrin, David; Cummings, Oscar.

In: Gastroenterology, Vol. 102, No. 4 PART 1, 1992, p. 1409-1418.

Research output: Contribution to journalArticle

Hirschowitz, BI, Griffith, J, Pellegrin, D & Cummings, O 1992, 'Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy', Gastroenterology, vol. 102, no. 4 PART 1, pp. 1409-1418.
Hirschowitz, Basil I. ; Griffith, James ; Pellegrin, David ; Cummings, Oscar. / Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy. In: Gastroenterology. 1992 ; Vol. 102, No. 4 PART 1. pp. 1409-1418.
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