{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T16:24:42Z","timestamp":1772727882464,"version":"3.50.1"},"reference-count":22,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1996,8]]},"abstract":"<jats:p>BACKGROUND: In patients with the Zollinger-Ellison syndrome, the exclusion of multiple endocrine neoplasia type 1 is of important clinical relevance. Its diagnosis often relies on the existence of primary hyperparathyroidism. AIM AND METHODS: To investigate the parathyroid function of patients with the Zollinger-Ellison syndrome by use of an oral calcium tolerance test to identify both hypercalcaemic and normocalcaemic primary hyperparathyroidism, and, accordingly, multiple endocrine neoplasia type 1. PATIENTS: Among 51 consecutive patients with the Zollinger-Ellison syndrome referred to us between 1988 and 1994, 28 had not been investigated for parathyroid function and were prospectively studied. RESULTS: The investigation of calcium metabolism was abnormal in nine patients. One displayed characteristic features of humoral hypercalcaemia of malignancy. The diagnosis of primary hyperparathyroidism was biologically established in eight patients (29%) and subsequently confirmed by the presence of hyperplasia of the parathyroid glands in the seven patients who underwent neck exploration. Three patients with primary hyperparathyroidism had fasting hyper-calcaemia but the other five had normal fasting serum total calcium concentration and the diagnosis of primary hyperparathyroidism was established by means of the oral calcium tolerance test. Primary hyperparathyroidism was demonstrated in the five patients in whom the diagnosis of multiple endocrine neoplasia type 1 had been previously established on other criteria than primary hyperparathyroidism. By contrast, in three patients, primary hyperparathyroidism, either hypercalcaemic (one patient) or normocalcaemic (two patients) was the sole criteria for the diagnosis of multiple endocrine neoplasia type 1. These results also suggest that primary hyperparathyroidism is present before or close to the time of Zollinger-Ellison syndrome diagnosis. CONCLUSION: Complete investigation of the parathyroid function with calcium calcium and parathyroid hormone concentrations.<\/jats:p>","DOI":"10.1136\/gut.39.2.273","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"273-278","source":"Crossref","is-referenced-by-count":20,"title":["Oral calcium tolerance test in the early diagnosis of primary hyperparathyroidism and multiple endocrine neoplasia type 1 in patients with the Zollinger-Ellison syndrome. Groupe de Recherche et d'Etude du Syndrome de Zollinger-Ellison."],"prefix":"10.1136","volume":"39","author":[{"given":"G","family":"Cadiot","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Houillier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Allouch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Paillard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Mignon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,8,1]]},"reference":[{"key":"ref_1","first-page":"342","article-title":"Management of islet cell tumors in patients with multiple endocrine neoplasia type 1","volume-title":"Endocrine tumors of the pancreas. Recent advances in research and management. Front Gastrointest Re3","volume":"23","author":"Mignon, M.; Cadiot, G.; Rigaud, D.; Ph, Ruszniewski; Jais, P.; Lehy, T.","year":"1995","unstructured":"Mignon M, Cadiot G, Rigaud D, Ruszniewski Ph, Jais P, Lehy T, et al. Management of islet cell tumors in patients with multiple endocrine neoplasia type 1. In: Mignon M, Jensen RT, eds. Endocrine tumors of the pancreas. Recent advances in research and management. Front Gastrointest Re3 Basel: Karger, 1995; 23: 342-59."},{"key":"ref_2","first-page":"931","article-title":"The pancreas: biology, pathobiology, and disease","author":"Jensen, R.T.","year":"1993","unstructured":"Jensen RT, Gardner JD, Gastrinoma. In: Go VLW, DiMagno EP, Gardner JD, Lebenthal E, Reber HA, Scheele GA, eds. The pancreas: biology, pathobiology, and disease. 2nd ed. New York: Raven Press, 1993: 931-78.","edition":"2nd ed"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/00006676-199305000-00003","article-title":"and evolutive features of patients with the Zollinger-Ellison syndrome combined with type 1 multiple endocrine neoplasia","volume":"8","author":"Ph, Ruszniewski; Ph, Podevin; G, Cadiot; JP, Marmuse; M, Mignon; C, Vissuzaine","year":"1993","unstructured":"Ruszniewski Ph, Podevin Ph, Cadiot G, Marmuse JP, Mignon M, Vissuzaine C, et al. Clinical, anatomical, and evolutive features of patients with the Zollinger-Ellison syndrome combined with type 1 multiple endocrine neoplasia. Pancreas 1993; 8: 295-304.","journal-title":"Pancreas"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3109\/02841869109092406","article-title":"Gastrinoma in multiple endocrine neoplasia type 1","volume":"30","author":"Lamers, C.B.H.W.","year":"1991","unstructured":"Lamers CBHW. Gastrinoma in multiple endocrine neoplasia type 1. Acta Oncol 1991; 30: 489-92.","journal-title":"Acta Oncol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/00000658-199206000-00002","article-title":"The Zollinger-Ellison syndrome. A collective surgical experience","volume":"215","author":"Farley, D.R.; Van Hoerden, J.A.; Grant, C.S.; Miller, U.; Ilstrup, D.M.","year":"1992","unstructured":"Farley DR, Van Hoerden JA, Grant CS, Miller U, Ilstrup DM. The Zollinger-Ellison syndrome. A collective surgical experience. Ann Surg 1992; 215: 561-70.","journal-title":"Ann Surg"},{"key":"ref_6","first-page":"436","article-title":"Zollinger-Ellison syndrome can be the initial endocrine manifestation in patients with multiple endocrine neoplasia-type 1","volume":"97","author":"Benya, R.V.; Metz, D.C.; Venzon, D.J.; Fishbeyn, V.A.; Strader, D.B.; Orbuch, M.","year":"1994","unstructured":"Benya RV, Metz DC, Venzon DJ, Fishbeyn VA, Strader DB, Orbuch M, et al. Zollinger-Ellison syndrome can be the initial endocrine manifestation in patients with multiple endocrine neoplasia-type 1. Am JMed 1994; 97: 436-44.","journal-title":"Am JMed"},{"key":"ref_7","first-page":"1183","article-title":"Long-term prognosis of Zollinger-Ellison syndrome in multiple endocrine neoplasia","volume":"114","author":"Melvin, W.S.; Johnson, J.A.; Sparks, J.; Innes, J.T.; Ellison, E.C.","year":"1993","unstructured":"Melvin WS, Johnson JA, Sparks J, Innes JT, Ellison EC. Long-term prognosis of Zollinger-Ellison syndrome in multiple endocrine neoplasia. Surgery 1993; 114: 1183-8.","journal-title":"Surgery"},{"key":"ref_8","first-page":"1108","article-title":"Management of islet cell tumors in patients with multiple endocrine neoplasia (MEN): a prospective study","volume":"106","author":"Sheppard, B.C.; Norton, J.A.; Doppman, J.L.; Maton, P.N.; Gardner, J.D.; Jensen, R.T.","year":"1989","unstructured":"Sheppard BC, Norton JA, Doppman JL, Maton PN, Gardner JD, Jensen RT. Management of islet cell tumors in patients with multiple endocrine neoplasia (MEN): a prospective study. Surgery 1989; 106: 1108-11.","journal-title":"Surgery"},{"key":"ref_9","first-page":"685","article-title":"Current diagnosis and management of Zollinger-Ellison syndrome","volume":"210","author":"Andersen, D.K.","year":"1989","unstructured":"Andersen DK. Current diagnosis and management of Zollinger-Ellison syndrome. Ann Surg 1989; 210: 685-703."},{"key":"ref_10","first-page":"1081","article-title":"The surgical treatment of gastrinoma in MEN I syndrome patients","volume":"106","author":"Thompson, N.W.; Bondeson, A.G.; Bondeson, L.; Vinik, A.","year":"1989","unstructured":"Thompson NW, Bondeson AG, Bondeson L, Vinik A. The surgical treatment of gastrinoma in MEN I syndrome patients. Surgery 1989; 106: 1081-6.","journal-title":"Surgery"},{"key":"ref_11","first-page":"958","article-title":"Effects of parathyroidectomy in patients with hyperparathyroidism and Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1","volume":"102","author":"Norton, J.A.; Doppman, J.L.; Comelius, M.J.; Maton, P.; Gardner, J.D.; Jensen, R.T.","year":"1987","unstructured":"Norton JA, Doppman JL, Comelius MJ, Maton P, Gardner JD, Jensen RT. Effects of parathyroidectomy in patients with hyperparathyroidism and Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1. Surgery 1987; 102: 958-66.","journal-title":"Surgery"},{"key":"ref_12","first-page":"60","article-title":"Genetics of multiple endocrine neoplasia type 1","volume-title":"tumors ofthe pancreas. Recent advances in research and management. Front Gastrointest Res","volume":"23","author":"Skogseid, B.; Oberg, K.","year":"1995","unstructured":"Skogseid B, Oberg K. Genetics of multiple endocrine neoplasia type 1. In: Mignon M, Jensen RT, eds. Endocrine tumors ofthe pancreas. Recent advances in research and management. Front Gastrointest Res. Basel: Karger, 1995; 23: 60-9."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1365-2265.1980.tb02704.x","article-title":"Primary hyperparathyroidism with intermittent hypercalcemia: serial observations and simple diagnosis by means of an oral calcium tolerance test","volume":"12","author":"Broadus, A.E.; Horst, R.L.; Littledike, E.T.; Mahaffey, J.E.; Rasmussen, H.","year":"1980","unstructured":"Broadus AE, Horst RL, Littledike ET, Mahaffey JE, Rasmussen H. Primary hyperparathyroidism with intermittent hypercalcemia: serial observations and simple diagnosis by means of an oral calcium tolerance test. Clin Endocrinol 1980; 12: 225-35.","journal-title":"Clin Endocrinol"},{"key":"ref_14","first-page":"301","article-title":"Normocalcemic primary hyperparathyroidism: resistance to PTH effect on tubular reabsorption of calcium","volume":"10","author":"Gardin, J.P.; Paillard, M.","year":"1984","unstructured":"Gardin JP, Paillard M. Normocalcemic primary hyperparathyroidism: resistance to PTH effect on tubular reabsorption of calcium. Miner Electrolyte Metab 1984; 10: 301-8.","journal-title":"Miner Electrolyte Metab"},{"key":"ref_15","first-page":"1103","article-title":"Role of the oral calcium-loading test with measurement of intact parathyroid hormone in the diagnosis of symptomatic subtle primary hyperparathyroidism","volume":"112","author":"Monchik, J.M.; Lamberton, R.P.; Roth, U.","year":"1992","unstructured":"Monchik JM, Lamberton RP, Roth U. Role of the oral calcium-loading test with measurement of intact parathyroid hormone in the diagnosis of symptomatic subtle primary hyperparathyroidism. Surgery 1992; 112: 1103-10.","journal-title":"Surgery"},{"issue":"98","key":"ref_16","first-page":"331","article-title":"Detection of primary hyperparathyroidism, with special reference to its occurrence in hypercalciuric females with 'normal' or borderline serum calcium","volume":"1968","author":"Yendt, E.R.; Gagne, R.J.A.","unstructured":"Yendt ER, Gagne RJA. Detection of primary hyperparathyroidism, with special reference to its occurrence in hypercalciuric females with 'normal' or borderline serum calcium. Can Med AssJ 1968; 98: 331-6.","journal-title":"Can Med AssJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1038\/ki.1987.125","article-title":"Renal mass and reserve of vitamin D: determinants in primary hyperparathyroidism","volume":"31","author":"Patron, P.; Gardin, J.P.; Paillard, M.","year":"1987","unstructured":"Patron P, Gardin JP, Paillard M. Renal mass and reserve of vitamin D: determinants in primary hyperparathyroidism. Kidney Int 1987; 31: 1174-80.","journal-title":"Kidney Int"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1093\/clinchem\/33.8.1364","article-title":"Highly sensitive two-site immunoradiometric assay of parathyrin and its clinical utility in evaluating patients with hypercalcemia","volume":"33","author":"Nussbaum, SR, Zahradnik; RJ, JR, Lavigne; Brennan, G.L.; Nozawa-Ung, K.; Kim, L.Y.","year":"1987","unstructured":"Nussbaum SR, Zahradnik RJ, Lavigne JR, Brennan GL, Nozawa-Ung K, Kim LY, et al. Highly sensitive two-site immunoradiometric assay of parathyrin and its clinical utility in evaluating patients with hypercalcemia. Clin Chem 1987; 33: 1364-7.","journal-title":"Clin Chem"},{"key":"ref_19","first-page":"677","article-title":"Diagnosis and treatment of ZollingerEllison syndrome. Bailleres Clin Gastroenterol","volume":"2","author":"Mignon, M.; Bonfils, S.","year":"1988","unstructured":"Mignon M, Bonfils S. Diagnosis and treatment of ZollingerEllison syndrome. Bailleres Clin Gastroenterol 1988; 2: 677-98."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1172\/JCI108831","article-title":"Nephrogenous cyclic adenosine monophosphate as a parathyroid function test","volume":"60","author":"Broadus, A.E.; Mahaffey, J.E.; Bartter, F.C.; Neer, R.M.","year":"1977","unstructured":"Broadus AE, Mahaffey JE, Bartter FC, Neer RM. Nephrogenous cyclic adenosine monophosphate as a parathyroid function test. J Clin Invest 1977; 60: 771-83.","journal-title":"J Clin Invest"},{"key":"ref_21","first-page":"1407","article-title":"Mineral metabolism","author":"Strewler, G.J.; Rosenblatt, M.","year":"1995","unstructured":"Strewler GJ, Rosenblatt M. Mineral metabolism. In: Felig P, Baxter JD, Frohman LA, eds. Endocrinology and metabolism. New York: McGraw-Hill, 1995: 1407-516."},{"key":"ref_22","first-page":"1703","article-title":"Multiglandular endocrine disorders","author":"Felig, P.","year":"1995","unstructured":"Deftos LJ, Catherwood BD, Bone III HG. Multiglandular endocrine disorders. In: Felig P, Baxter JD, Frohman LA, eds. Endocrinology and metabolism. New York: McGrawHill, 1995: 1703-32."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.39.2.273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T10:04:54Z","timestamp":1765620294000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.39.2.273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,8]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1996,8,1]]},"published-print":{"date-parts":[[1996,8]]}},"alternative-id":["10.1136\/gut.39.2.273"],"URL":"https:\/\/doi.org\/10.1136\/gut.39.2.273","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,8]]}}}