Peptic ulceration is associated with hypercalcaemia in a number of disease states including isolated primary hyperparathyroidism and multiple endocrine neoplasia (e.g. MEN1 syndrome where hyperparathyroidism co-exists with gastrinomas and the Zollinger Ellison Syndrome). Hypercalcaemia is also known to enhance gastrin secretion. We were therefore interested in investigating whether any association exists between serum calcium concentrations and the findings at oesophago-gastro-duodenoscopy in a general population referred for investigation of dyspeptic symptoms. We recruited 40 patients in each of three groups; (a) with a proven diagnosis of peptic ulcer disease (gastric or duodenal), (b) with a diagnosis of gastritis and/or duodenitis and (c) with mild oesophagitis (grades 1a or 1b) all made by upper gastrointestinal endoscopy performed at a single district general hospital in South Wales. The group with peptic ulcers was generally older than the groups with non-ulcer disease (group a, mean age = 64.9 years, group b, mean age 54 years and group c, mean age 59 years). A biochemical profile, including serum calcium, phosphate, albumin and alkaline phosphatase was available in 31 of the patients with peptic ulcers, 26 of the patients with gastritis/duodenitis and 21 of the patients with mild oesophagitis. The corrected serum calcium concentrations were 2.41 plus or minus 0.1 (standard deviation) mM in the patients with peptic ulcer, 2.43 plus or minus 0.12 mM in the group with gastritis and 2.40 plus or minus 0.1 mM in the group with mild oesophagitis (p non-significant by chi squared for all comparisons). We conclude that serum calcium is routinely measured in the majority of patients undergoing endoscopy for dyspeptic symptoms but that there is no association between the corrected serum levels and the endoscopic diagnosis.
22 - 24 Mar 2004
British Endocrine Societies