Hypergastrinemia

The Correct Answer is A. Adrenal insufficiency

Hypergastrinemia can result from a variety of causes. Hypergastrinemia that results from administration of antisecretory agents is an appropriate response caused by loss of feedback inhibition of gastrin release by luminal acid. Lack of acid causes a reduction in somatostatin release, which in turn causes increased release of gastrin from antral G cells. Hypergastrinemia can also occur in the setting of pernicious anemia or uremia or following surgical procedures such as vagotomy or retained gastric antrum after gastrectomy. In contrast, gastrin levels increase inappropriately in patients with gastrinoma (Zollinger-Ellison syndrome). These gastrin-secreting tumors are not located in the antrum and secrete gastrin autonomously. The clinical triad of Zollinger-Ellison syndrome is the finding of gastric acid hypersecretion, severe peptic ulcer disease, and a non-beta islet cell tumor of the pancreas .

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