Zollinger-Ellison syndrome is caused by non-beta islet cells of gastrin-secreting tumors of the pancreas, which stimulate acid-secreting cells of the stomach to maximum activity, followed by gastric ulceration of the mucous membrane. The syndrome may occur sporadically or as part of an autosomal dominant familial syndrome of multiple endocrine neoplasia. The primary tumor is usually found in the duodenum, pancreas, and lymph nodes of the abdominal cavity, but ectopic sites are also often affected.
Pathophysiology
The symptoms of Zollinger-Ellison syndrome are considered secondary to hypergastrinemia, which causes hypertrophy of the gastric mucosa, which leads to an increase in the number of parietal cells and an increase in the production of maximal acid. Gastrin itself also stimulates acid secretion, which leads to increased basal acid secretion. The huge concentration of acid produced leads to gastrointestinal tract through mucosal ulceration. It also leads to diarrhea and malabsorption.
Enteropathies in the syndrome are usually multifactorial, being caused by direct damage to the mucous membrane by acid, inactivation of enzymes in the pancreatic region, as well as precipitation of bile salts. The syndrome is sporadic in 75% of patients, while in the other 25% it is associated with an autosomal dominant condition characterized by hyperparathyroidism, pancreatic endocrine tumors and pituitary tumors.
Etiology
The syndrome can be detected sporadically or as part of a multiple type of endocrine neoplasia type 1.
Epidemiology
Zollinger-Ellison syndrome was detected in approximately 0.1-2% of all patients with duodenal colitis. Its incidence is reported to be about the same as insulinomas, the most common functional disorders of the pancreas and endocrine tumors. All races can be affected. There is a slight predominance of men, with a male-to-female ratio of 1.3:1.
The average age of onset of the syndrome is 44 years. However, in patients with multiple endocrine neoplasia type 1, the syndrome occurs 10 years earlier. As a rule, there is a delay of 5 to 7 years in diagnosis. In a prospective study, less than 5% of patients were under the age of 20, while 8% were over the age of 65 at the time of disease onset. Commencer sur une plateforme de paris avec un capital renforcé change toute l’expérience de jeu. Les bonus bien conçus offrent un avantage réel aux nouveaux membres. Au milieu des promotions les plus intéressantes figure le code promo 1xbet aujourd'hui particulièrement recommandé. En l’utilisant lors de votre inscription, vous obtenez jusqu’à 130 € de bonus sur votre premier dépôt. Ce bonus vous ouvre les portes vers une large gamme d’événements sportifs.
