Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Most patients with MEN1 present with hypercalcaemia due to primary hyperparathyroidism.
A 32-year-old man presents with recurrent peptic ulcers, abdominal pain, and diarrhoea. Examination shows mild features of hypercalcaemia (thirst, constipation). Blood tests reveal raised serum calcium and PTH, consistent with primary hyperparathyroidism, and elevated gastrin levels. MRI pituitary later shows a prolactin-secreting adenoma. Family history reveals his father had similar endocrine tumours. 👉 Diagnosis: MEN1 (parathyroid hyperplasia, pancreatic neuroendocrine tumour, pituitary adenoma). 👉 Management: surgery for hyperparathyroidism, proton pump inhibitors for gastrinoma, dopamine agonists for prolactinoma, and genetic counselling.