Screening for multiple endocrine neoplasia syndrome (type 1) in patients with primary hyperparathyroidism.

Abstract:

:In 63 consecutive patients with primary hyperparathyroidism (HPT) a prospective screening study was undertaken for coexistent multiple endocrine neoplasma-(MEN)-syndrome type 1. The screening consisted of a clinical examination, a radiological examination of the sella turcica with skeletal tomography (and in equivocal cases computed tomography), visual field examination by perimetry and a hormonal evaluation including measurements of the serum levels of prolactin, gastrin, pancreatic polypeptide (PP) and subunits of human chorionic gonadotrophin (HCG-alpha and -beta). Clinical examination did not reveal any signs of endocrine disease suggestive of a MEN-1 syndrome. In only one case there was a radiological abnormality of the sella turcica; this patient had an empty sella syndrome and a raised serum prolactin value. All other prolactin values were within the normal range. In 41% of the patients raised serum gastrin levels were found; these tended to normalize after parathyroidectomy. As a group, patients with raised gastrin values were older than the others and generally they had hypo- or achlorhydria. The serum PP levels were raised in 28% of the patients but there was no clinical evidence of a pancreatic tumour in any of these cases, and the serum HCG-alpha and -beta levels were within the normal range in all patients but two. We conclude that the incidence of MEN-1 syndrome in unselected patients with primary HPT must be low, and that investigations for this syndrome are justified only in HPT patients with specific symptoms or with a positive family history.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Muhr C,Ljunghall S,Akerstrom G,Palmér M,Bergström K,Enoksson P,Lundqvist G,Wide L

doi

10.1111/j.1365-2265.1984.tb00070.x

subject

Has Abstract

pub_date

1984-02-01 00:00:00

pages

153-62

issue

2

eissn

0300-0664

issn

1365-2265

journal_volume

20

pub_type

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