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.

• Authors: C Muhr, S Ljunghall, G Akerstrom, M Palmér, K Bergström, P Enoksson, G Lundqvist, L Wide
• Journal: Clinical endocrinology (Clin Endocrinol (Oxf)) Vol. 20 Issue 2 Pg. 153-62 (Feb 1984) ISSN: 0300-0664 [Print] England
• PMID: 6143630 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Chorionic Gonadotropin
• Gastrins
• Pancreatic Polypeptide
• Prolactin

Topics

• Adult
• Aged
• Chorionic Gonadotropin (blood)
• Female
• Gastrins (blood)
• Humans
• Hyperparathyroidism (blood, complications)
• Male
• Middle Aged
• Multiple Endocrine Neoplasia (blood, complications, diagnosis)
• Pancreatic Polypeptide (blood)
• Prolactin (blood)
• Radiography
• Sella Turcica (diagnostic imaging)