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Zollinger-Ellison syndrome(ZES)

MedGen UID:
53129
Concept ID:
C0043515
Disease or Syndrome
Synonyms: Gastrinoma; Pancreatic ulcerogenic tumor syndrome; Z E syndrome; ZES
SNOMED CT: Excessive gastrin secretion (53132006); ZE - Zollinger-Ellison syndrome (53132006); Zollinger-Ellison syndrome (53132006)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
Concept ID:
CN307044
Finding
Source: Orphanet
clinical entity without genetic inheritance.
 
HPO: HP:0002044
Monarch Initiative: MONDO:0019610
Orphanet: ORPHA913

Definition

A condition in which there is increased production of gastrin by a gastrin-secreting tumor (usually located in the pancreas, duodenum, or abdominal lymph nodes) that stimulates the gastric mucosa to maximal activity, with consequent gastrointestinal mucosal ulceration. [from HPO]

Conditions with this feature

Multiple endocrine neoplasia, type 1
MedGen UID:
9957
Concept ID:
C0025267
Neoplastic Process
Multiple endocrine neoplasia type 1 (MEN1) includes varying combinations of more than 20 endocrine and non-endocrine tumors. Endocrine tumors become evident either by overproduction of hormones by the tumor or by growth of the tumor itself. Parathyroid tumors are the most common MEN1-associated endocrinopathy; onset in 90% of individuals is between ages 20 and 25 years with hypercalcemia evident by age 50 years; hypercalcemia causes lethargy, depression, confusion, anorexia, constipation, nausea, vomiting, diuresis, dehydration, hypercalciuria, kidney stones, increased bone resorption/fracture risk, hypertension, and shortened QT interval. Pituitary tumors include prolactinoma (the most common), which manifests as oligomenorrhea/amenorrhea and galactorrhea in females and sexual dysfunction in males. Well-differentiated endocrine tumors of the gastro-entero-pancreatic (GEP) tract can manifest as Zollinger-Ellison syndrome (gastrinoma); hypoglycemia (insulinoma); hyperglycemia, anorexia, glossitis, anemia, diarrhea, venous thrombosis, and skin rash (glucagonoma); and watery diarrhea, hypokalemia, and achlorhydria syndrome (vasoactive intestinal peptide [VIP]-secreting tumor). Carcinoid tumors are non-hormone-secreting and can manifest as a large mass after age 50 years. Adrenocortical tumors can be associated with primary hypercortisolism or hyperaldosteronism. Non-endocrine tumors include facial angiofibromas, collagenomas, lipomas, meningiomas, ependymomas, and leiomyomas.
Marden-Walker syndrome
MedGen UID:
163206
Concept ID:
C0796033
Disease or Syndrome
Marden-Walker syndrome (MWKS) is characterized by psychomotor retardation, a mask-like face with blepharophimosis, micrognathia and a high-arched or cleft palate, low-set ears, kyphoscoliosis, and joint contractures. Other features may include Dandy-Walker malformation with hydrocephalus and vertebral abnormalities (summary by Schrander-Stumpel et al., 1993). There are 2 distal arthrogryposis syndromes with features overlapping those of Marden-Walker syndrome that are also caused by heterozygous mutation in PIEZO2: distal arthrogryposis type 3 (DA3, or Gordon syndrome; 114300) and distal arthrogryposis type 5 (DA5; 108145), which are distinguished by the presence of cleft palate and ocular abnormalities, respectively. McMillin et al. (2014) suggested that the 3 disorders may represent variable expressivity of the same condition.

Professional guidelines

PubMed

Rossi RE, Elvevi A, Citterio D, Coppa J, Invernizzi P, Mazzaferro V, Massironi S
World J Gastroenterol 2021 Sep 21;27(35):5890-5907. doi: 10.3748/wjg.v27.i35.5890. PMID: 34629807Free PMC Article
Norton JA, Foster DS, Ito T, Jensen RT
Endocrinol Metab Clin North Am 2018 Sep;47(3):577-601. doi: 10.1016/j.ecl.2018.04.009. PMID: 30098717Free PMC Article
Sato Y, Hashimoto S, Mizuno K, Takeuchi M, Terai S
World J Gastroenterol 2016 Aug 14;22(30):6817-28. doi: 10.3748/wjg.v22.i30.6817. PMID: 27570419Free PMC Article

Recent clinical studies

Etiology

Rossi RE, Elvevi A, Citterio D, Coppa J, Invernizzi P, Mazzaferro V, Massironi S
World J Gastroenterol 2021 Sep 21;27(35):5890-5907. doi: 10.3748/wjg.v27.i35.5890. PMID: 34629807Free PMC Article
Lee L, Ramos-Alvarez I, Ito T, Jensen RT
Int J Mol Sci 2019 Oct 16;20(20) doi: 10.3390/ijms20205128. PMID: 31623145Free PMC Article
Savarino V, Marabotto E, Zentilin P, Furnari M, Bodini G, De Maria C, Pellegatta G, Coppo C, Savarino E
Expert Rev Clin Pharmacol 2018 Nov;11(11):1123-1134. Epub 2018 Oct 10 doi: 10.1080/17512433.2018.1531703. PMID: 30295105
Norton JA, Foster DS, Blumgart LH, Poultsides GA, Visser BC, Fraker DL, Alexander HR, Jensen RT
JAMA Surg 2018 Mar 1;153(3):e175083. doi: 10.1001/jamasurg.2017.5083. PMID: 29365025Free PMC Article
Ito T, Igarashi H, Jensen RT
Best Pract Res Clin Gastroenterol 2012 Dec;26(6):737-53. doi: 10.1016/j.bpg.2012.12.003. PMID: 23582916Free PMC Article

Diagnosis

Binet Q, Borbath I
N Engl J Med 2022 Nov 3;387(18):1699. doi: 10.1056/NEJMicm2203797. PMID: 36322847
Rossi RE, Elvevi A, Citterio D, Coppa J, Invernizzi P, Mazzaferro V, Massironi S
World J Gastroenterol 2021 Sep 21;27(35):5890-5907. doi: 10.3748/wjg.v27.i35.5890. PMID: 34629807Free PMC Article
Zimmer V, Glanemann M, Lammert F
CMAJ 2019 Dec 9;191(49):E1358. doi: 10.1503/cmaj.191047. PMID: 31818929Free PMC Article
De Angelis C, Cortegoso Valdivia P, Venezia L, Bruno M, Pellicano R
Minerva Endocrinol 2018 Jun;43(2):212-220. Epub 2017 Sep 25 doi: 10.23736/S0391-1977.17.02745-6. PMID: 28949124
Ito T, Cadiot G, Jensen RT
World J Gastroenterol 2012 Oct 21;18(39):5495-503. doi: 10.3748/wjg.v18.i39.5495. PMID: 23112541Free PMC Article

Therapy

Sharma P
J Assoc Physicians India 2023 Aug;71(8):11-12. doi: 10.59556/japi.71.0322. PMID: 37651247
Lee L, Ramos-Alvarez I, Ito T, Jensen RT
Int J Mol Sci 2019 Oct 16;20(20) doi: 10.3390/ijms20205128. PMID: 31623145Free PMC Article
Norton JA, Foster DS, Blumgart LH, Poultsides GA, Visser BC, Fraker DL, Alexander HR, Jensen RT
JAMA Surg 2018 Mar 1;153(3):e175083. doi: 10.1001/jamasurg.2017.5083. PMID: 29365025Free PMC Article
Ito T, Igarashi H, Uehara H, Jensen RT
Expert Opin Pharmacother 2013 Feb;14(3):307-21. Epub 2013 Jan 30 doi: 10.1517/14656566.2013.767332. PMID: 23363383Free PMC Article
Ito T, Igarashi H, Jensen RT
Best Pract Res Clin Gastroenterol 2012 Dec;26(6):737-53. doi: 10.1016/j.bpg.2012.12.003. PMID: 23582916Free PMC Article

Prognosis

Norton JA, Foster DS, Blumgart LH, Poultsides GA, Visser BC, Fraker DL, Alexander HR, Jensen RT
JAMA Surg 2018 Mar 1;153(3):e175083. doi: 10.1001/jamasurg.2017.5083. PMID: 29365025Free PMC Article
De Angelis C, Cortegoso Valdivia P, Venezia L, Bruno M, Pellicano R
Minerva Endocrinol 2018 Jun;43(2):212-220. Epub 2017 Sep 25 doi: 10.23736/S0391-1977.17.02745-6. PMID: 28949124
Ito T, Igarashi H, Jensen RT
Curr Opin Gastroenterol 2013 Nov;29(6):650-61. doi: 10.1097/MOG.0b013e328365efb1. PMID: 24100728Free PMC Article
Ito T, Igarashi H, Uehara H, Berna MJ, Jensen RT
Medicine (Baltimore) 2013 May;92(3):135-181. doi: 10.1097/MD.0b013e3182954af1. PMID: 23645327Free PMC Article
Metz DC
Ital J Gastroenterol Hepatol 1999 Oct;31 Suppl 2:S153-9. PMID: 10604121

Clinical prediction guides

Imamura M, Komoto I, Taki Y
Surg Today 2023 Dec;53(12):1325-1334. Epub 2022 Dec 7 doi: 10.1007/s00595-022-02627-z. PMID: 36473964Free PMC Article
Massironi S, Cavalcoli F, Elvevi A, Quatrini M, Invernizzi P
Endocrine 2022 Mar;75(3):942-948. Epub 2021 Oct 29 doi: 10.1007/s12020-021-02915-7. PMID: 34716542
Lee L, Ramos-Alvarez I, Ito T, Jensen RT
Int J Mol Sci 2019 Oct 16;20(20) doi: 10.3390/ijms20205128. PMID: 31623145Free PMC Article
Jani N, Moser AJ, Khalid A
Gastroenterol Clin North Am 2007 Jun;36(2):431-9, x-xi. doi: 10.1016/j.gtc.2007.03.002. PMID: 17533088
Hirschowitz BI
Yale J Biol Med 1992 Nov-Dec;65(6):659-76; discussion 689-92. PMID: 1341070Free PMC Article

Recent systematic reviews

Othman MO, Harb D, Barkin JA
Int J Clin Pract 2018 Feb;72(2) Epub 2018 Feb 5 doi: 10.1111/ijcp.13066. PMID: 29405509Free PMC Article
Boghossian TA, Rashid FJ, Thompson W, Welch V, Moayyedi P, Rojas-Fernandez C, Pottie K, Farrell B
Cochrane Database Syst Rev 2017 Mar 16;3(3):CD011969. doi: 10.1002/14651858.CD011969.pub2. PMID: 28301676Free PMC Article
Song H, Zhu J, Lu D
Cochrane Database Syst Rev 2014 Dec 2;2014(12):CD010623. doi: 10.1002/14651858.CD010623.pub2. PMID: 25464111Free PMC Article
Gill SK, O'Brien L, Einarson TR, Koren G
Am J Gastroenterol 2009 Jun;104(6):1541-5; quiz 1540, 1546. Epub 2009 Apr 28 doi: 10.1038/ajg.2009.122. PMID: 19491869

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