Multiple Endocrine Neoplasia (MEN) I

Alternative names:

Wermer's syndrome

Symptoms:

Symptoms vary greatly from person to person and may be related to peptic ulcer disease, hypoglycemia, hypercalcemia, or pituitary dysfunction.

• abdominal pain
• burning, aching, or hunger discomfort in the upper abdomen or lower chest that is relieved by antacids, milk, or food
• black, tarry stools
• nausea and vomiting
• bloated feeling after meals
• weakness
• headache
• hunger
• vision problems
• loss of coordination
• anxiety
• mental changes or confusion
• coma if hypoglycemia is untreated
• loss of appetite
• muscle pain
• fatigue
• sensitivity to the cold
• weight loss
• low blood pressure
• visual disturbances
• loss of axillary or pubic hair
• in women, cessation of menses, infertility, or failure to lactate
• in men, decreased sexual interest, loss of body or facial hair
• fatty nodules under the skin

Signs and tests:

Diagnostic tests are used to evaluate the function of each endocrine gland.

Pancreatic evaluation may reveal the following signs:

• An MRI of abdomen shows a pancreatic tumor.
• A CT of abdomen shows a pancreatic tumor.
• An insulin test may show increased levels.
• Fasting blood sugar may be low.
• Serum glucagon may be elevated.

Parathyroid evaluation may reveal the following signs:

• The serum calcium level is elevated, and the serum parathormone is increased.
• A parathyroid biopsy shows tumor or hyperplasia

Pituitary evaluation may reveal the following signs:

• A cranial CT scan or MRI of head may reveal a pituitary tumor.

The following hormone levels may also be measured to evaluate the pituitary:

• serum thyroid stimulating hormone (rarely used).
• cortisol level
• serum adrenocorticotropic hormone level
• serum luteinizing hormone
• serum follicle stimulating hormone

Additional testing may be indicated.