To the Editor.
—The article by Zaniewski et al in the March 1986 issue of the Archives1 concerning a possible relationship between hypergastrinemia and chronic hypercalcemia of various causes, unfortunately further clouds an already confusing issue. The authors attribute elevated gastrin levels to chronic hypercalcemia, a leap of faith that ignores other factors that could explain these findings. The gastrin assay was performed on serum originally obtained for immunoreactive parathyroid hormone. As no mention was made as to the time of day that the samples were drawn, it is possible that some were obtained from non-fasted patients. Feeding normally causes a gastrin level rise of 70 to 120 pg/mL over basal in healthy controls.2 Therefore, some of the modest elevations in gastrin among the hypercalcemic patients in this type of study may have resulted from a lack of controlled prospective study conditions.Our major criticism is the lack