thiourea and Zollinger-Ellison-Syndrome

The histamine H2-receptor antagonist metiamide is an inhibitor of endogenous and stimulated gastric-acid secretion. It appears to have therapeutic possibilities in duodenal-ulcer disease. Three patients exhibiting the Zollinger-Ellison syndrome have been treated with this drug for six months or more. Rapid symptomatic improvement occurred in each case, followed by ulcer healing. There were also reductions in gastric secretion and consistent changes in the fasting serum-gastrin concentration. On patient relapsed temporarily during therapy. There have been no side effects. It is concluded that, in the short term, metiamide is of benefit in the Zollinger-Ellison syndrome.

Topics: Adult; Clinical Trials as Topic; Drug Evaluation; Female; Gastric Juice; Gastrins; Humans; Male; Metiamide; Middle Aged; Remission, Spontaneous; Thiourea; Zollinger-Ellison Syndrome

Topics: Adult; Dose-Response Relationship, Drug; Histamine H2 Antagonists; Humans; Male; Metiamide; Middle Aged; Thiourea; Zollinger-Ellison Syndrome

Continuous treatment of three Zollinger-Ellison patients with histamine H2-receptor antagonists for 14, 26 and 31 months resulted in effective relief of complaints and marked reduction in gastric acid secretion. In one of the patients the dose of cimetidine had to be doubled after 15 months of treatment because of a rise in basal gastric acid secretion accompanied by recurrent diarrhea. Fasting and secretin-stimulated serum gastrin levels were not affected by long-term treatment with histamine H2-receptor antagonists. No side-effects were observed in the three patients on long-term treatment.

Topics: Adult; Cimetidine; Depression, Chemical; Drug Evaluation; Female; Gastric Juice; Gastric Mucosa; Guanidines; Humans; Male; Metiamide; Thiourea; Time Factors; Zollinger-Ellison Syndrome

Topics: Adult; Cimetidine; Female; Gastric Juice; Gastrins; Guanidines; Humans; Male; Metiamide; Thiourea; Zollinger-Ellison Syndrome

Five patients with Zollinger-Ellison syndrome received metiamide per os in doses ranging from 600 to 1,200 mg/day for a minimum period of 2 weeks. Drug produced an inhibition of basal gastric acid secretion ranging from 5 to 100% with relief of symptoms. Survey of patients during and after metiamide course showed sometimes a prolonged antisecretory effect up to 26 days after the end of treatment or, on the contrary, a reduced drug activity in spite of increasing doses.

Topics: Adult; Dose-Response Relationship, Drug; Female; Gastric Juice; Gastrins; Humans; Male; Metiamide; Middle Aged; Secretory Rate; Thiourea; Time Factors; Zollinger-Ellison Syndrome

Inhibition of acid secretion by an H2-receptor antagonist (metiamide) was assessed in three patients with the Zollinger-Ellison syndrome. Metiamide (200 or 300 mg) inhibited acid secretion transiently (2 1/2 hours) by 85 to 100 per cent in all patients. Although anticholinergic drugs alone inhibited acid secretion by only 0 to 35 per cent in these patients, the combination of metiamide and anticholinergic markedly prolonged the inhibitory effect of metiamide. Total gastrectomy was refused by one patient, and was impossible in another; both were treated with metiamide and anticholinergic for five and 10 months. A third patient was treated with metiamide and anticholinergic for three weeks in preparation for total gastrectomy. Ulcer pain and diarrhea disappeared, and each gained weight. H2-receptor antagonists may be useful in the treatment of some patients with the Zollinger-Ellison syndrome.

Topics: Adult; Drug Evaluation; Drug Therapy, Combination; Female; Glycopyrrolate; Histamine H1 Antagonists; Humans; Male; Metiamide; Propantheline; Receptors, Drug; Thiourea; Time Factors; Zollinger-Ellison Syndrome

Topics: Antibody Formation; Guanidines; Histamine H1 Antagonists; Humans; Imidazoles; Metiamide; T-Lymphocytes; Thiourea; Zollinger-Ellison Syndrome

Two cases of Zollinger-Ellison syndrome are reported in which metiamide produced marked reduction in gastric acid secretion and control of symptoms, so that elective gastrectomy was performed without mortality or morbidity.

Topics: Depression, Chemical; Female; Gastric Juice; Humans; Metiamide; Middle Aged; Preoperative Care; Thiourea; Zollinger-Ellison Syndrome

Topics: Adult; Histamine; Humans; Male; Metiamide; Receptors, Drug; Thiourea; Zollinger-Ellison Syndrome

Metiamide an histamine H2-receptors antagonist has been used to treat a case of Zollinger-Ellison syndrome characterized by a long standing diarrhea, an important gastric hypersecretion and a moderatly elevated plasma gastrin but without digestive ulceration. At the dose of 600 mg per day, Metiamide induced a complete suppression of acid secretion, an effect which lasted for 15 days after stopping the drug. Accordingly and since the only finding at time of laparotomy was a small lymph node enlarged with endocrine metastatic tissue, the stomach was left intact and Metiamide pursued. During the first 4 months of chronic administration of Metiamide, acid secretion was maintained at levels below 25 p.cent of initial values. Ulteriorly however, although dosages of Metiamide were increased, acid hypersecretion resumed and a duodenal ulcer developed. Total gastrectomy was then performed 11 months after the beginning of Metiamide. In spite of the failure of Metiamide treatment, the long term follow up of this case of Zollinger-Ellison Syndrome, allowed us to get theoretical and practical informations.

Topics: Adult; Delayed-Action Preparations; Duodenal Ulcer; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Histamine H1 Antagonists; Humans; Male; Metiamide; Middle Aged; Receptors, Drug; Secretin; Secretory Rate; Thiourea; Zollinger-Ellison Syndrome

Topics: Adult; Gastrins; Humans; Imidazoles; Male; Radioimmunoassay; Sulfides; Thiourea; Zollinger-Ellison Syndrome

Topics: Adult; Alkalosis; Histamine H1 Antagonists; Humans; Imidazoles; Infusions, Parenteral; Male; Sulfides; Thiourea; Zollinger-Ellison Syndrome

Topics: Gastrins; Imidazoles; Sulfides; Thiourea; Zollinger-Ellison Syndrome

Topics: Administration, Oral; Adult; Depression, Chemical; Gastric Acidity Determination; Gastric Juice; Humans; Male; Metiamide; Propantheline; Thiourea; Zollinger-Ellison Syndrome