Gastrinoma vs. Zollinger Ellison

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Does anyone know why a gastrinoma, per FA, says that its ulcers are refractory to therapy? (ex PPI). BUT it says Zollinger Ellison is treated with PPIs. Is this just reffering to the symptoms of ZE? im confused here haha
 
Does anyone know why a gastrinoma, per FA, says that its ulcers are refractory to therapy? (ex PPI). BUT it says Zollinger Ellison is treated with PPIs. Is this just reffering to the symptoms of ZE? im confused here haha

They're frequently refractory, but you won't know that it's refractory unless you try to treat it. So you would start the ZE pt on a PPI knowing that it probably won't work, but PPIs are cheap and there aren't significant short term side effects.
 
Refractory only means that they are difficult to treat (requires higher doses and longer duration) NOT that they are ineffective.
 
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