Serum albumin levels in patients with the Zollinger-Ellison syndrome.

Serum albumin concentrations in 20 patients with proved or presumed Zollinger-Ellison (ZE) syndrome (4.1 +/- 0.8 g per 100 ml; mean +/- SD) were significantly (P less than 0.01) lower than the levels observed in 40 normal controls (5.1 +/- 0.3 g per 100 ml), 40 duodenal ulcer patients (5.1 +/- 0.4 g per 100 ml), and 20 stomal ulcer patients (5.1 +/- 0.3 g per 100 ml). Six ZE patients with metastatic gastrinoma had slightly lower (P less than 0.10) serum albumin concentrations (3.5 +/- 0.9 g per 100 ml) than did 14 ZE patients without evidence of metastatic lesions (4.3 +/- 0.7 g per 100 ml). In a small group of patients studied more extensively, the mechanism of hypoalbuminemia was found to be complex. In addition to metastatic tumor growth, both gastrointestinal protein loss and impaired albumin synthesis may be factors in the pathogenesis of hypoalbuminemia. Inadequate nutrition was only evident in 1 patient with esophageal stricture and in 2 patients with extensive tumor growth after total gastrectomy. Total gastrectomy induced a rise in serum albumin in all 8 patients studied (P = 0.01). It is concluded that low serum albumin concentrations in peptic ulcer patients may be a clue to the diagnosis of ZE syndrome.