Multiple Endocrine Neoplasia

November 12, 2012

Multiple Endocrine Neoplasia

This is an inherited disorder, which affects one of the endocrine glands such as the pancreas, parathyroid or pituitary gland.

Causes of multiple endocrine neoplasia

Multiple endocrine neoplasia (MEN) type I is a disorder involving one or more of the endocrine glands. The gland may have become overactive or formed a tumour and most commonly involves the pancreas, parathyroid or pituitary gland and is not necessarily restricted to affect only one. Multiple endocrine neoplasia is an inherited condition, caused by a defect gene that is passed down through families. The gene is the one responsible for carrying the code of a protein known as menin. The condition leads to the development of tumours to appear on various glands but not necessarily at the same time. It can affect people of all ages and men and women are equally likely to develop it. The individual most likely to develop multiple endocrine neoplasia is the one who has a family history of the condition, although a family history does not guarantee that you will ever develop it.

Symptoms of multiple endocrine neoplasia

There are various symptoms of the condition and they depend largely on what gland has been affected. Some of the more common symptoms include:

  • Fatigue

  • Headaches

  • Loss of appetite

  • Anxiety

  • Abdominal pain

  • Loss of coordination

  • Loss of body or facial hair

  • Decreased sexual libido

  • Muscle pain

  • Mental changes and confusion

  • Nausea and Vomiting

  • Sensitivity to extreme temperatures

  • Unintentional weight loss

  • Weakness

  • Problems with vision

  • Unexpected change in menstrual periods

  • Black stools

  • Burning, aching or discomfort in the upper abdomen or lower chest

Testing and Diagnosis of multiple endocrine neoplasia

There are a great number of tests that can be done when testing for tumours associated with MEN type I. Some of them include:

  • Blood cortisole level

  • CT scan of the abdomen or head

  • Insulin test

  • MRI of the abdomen or head

  • Parathyroid biopsy

  • Serum calcium

  • Serum follicle stimulating hormone

  • Serum glucagon

  • Serum thyroid stimulating hormone

  • Ultrasound of the neck

Treatment for multiple endocrine neoplasia

The primary and preferred treatment is to surgically remove the affected gland. In the case of the affected gland being the pituitary gland, a medication called bromocriptine may be chosen instead of surgery. Hormone replacement therapy is sometimes required when an entire gland has been removed and there is a lack of a certain hormone being produced. Depending on the location of the tumour it may be benign or cancerous. If the cancer is allowed to spread to the liver, life expectancy can be shortened. Therefore any symptoms should be recognised and treated as quickly as possible in order to get the best outcome.

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