gastrins and Infant--Newborn--Diseases

We describe the case of an apparently healthy newborn infant who in 7th day of life showed an episode of haematemesis and in 13th day of life presented an episode of apparent life threatening event (ALTE). A fibroscopy of the upper digestive tract showed a great ulcer of the gastric antrum and esophagitis limited to the mucosa. Gastrinemia in the blood showed high values (121 pg/ml). The relationship between ALTE and gastric ulcer may be casual, however in literature a gastroenteric cause is present in about 50% of ALTE in which an etiologic cause is found. We speculate that in the present case the increase of gastrin secretion reduced gastric pH which facilitated the onset of gastric ulcer and esophagitis with ALTE due to pain or reflex.

Topics: Biopsy; Critical Illness; Gastrins; Gestational Age; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Male; Pyloric Antrum; Stomach Ulcer

Topics: Calcitonin; Calcium; Gastrins; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Magnesium; Parathyroid Hormone; Phosphorus

Oral calcium supplements (80 mg/kg per 24 h) were given to 23 preterm infants, and the course of serum calcium, magnesium, immunoreactive calcitonin, and gastrin was compared with a control group of 23 matched infants. In the supplemented group, serum calcium concentrations remained at the baseline level (2.31 mmol/l +/- 0.18 SD) while a fall (from 2.27 +/- 0.18 to 1.91 +/- 0.24 mmol/l) was observed at 12-16 hours of age in the control group, with 4 values < 1.75 mmol/l. There was no change in serum magnesium concentration in either group. The postnatal rise of serum immunoreactive calcitonin concentrations in the control group (from 171 +/- 135 to 493 +/- 273 pg/ml at 12-48 hours of age) was not found in the supplemented group. There was a negative correlation between serum calcium and immunoreactive calcitonin levels in the control group, but not in the supplemented group. There was no correlation between serum immunoreactive calcitonin and gastrin concentrations. These data show that oral calcium supplementation can prevent early neonatal hypocalcaemia, and suggest that this effect is achieved at least in part through a reduction of the postnatal rise of serum immunoreactive calcitonin.

Topics: Calcitonin; Calcium; Food, Fortified; Gastrins; Humans; Hypocalcemia; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Magnesium

Gastrin has a regulating effect on the complicated closing mechanism of the lower oesophageal sphincter. This hormone produced in G-cells of the pyloric antrum and carried by the blood stream has its greatest effect on the anterior fundus wall, cardias and the lower oesophageal sphincter. Thus, when there is a failure in the closing mechanism of the lower oesophageal sphincter produced by lacking maturity of the oesophageal fibers and the cardias zone, only those surgical procedures using the gastric fundus in order to correct the failure can guarantee a good result, if medical treatment has not been successful. The authors comment on the physiological basis of the treatment, the medical as well as the surgical one, of the gastro-oesophageal reflux.

Topics: Esophagogastric Junction; Gastrins; Gastroesophageal Reflux; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pyloric Antrum