Multiple endocrine neoplasia type 1 presenting as hypoglycemic coma :a report of four cases and review of literatures / 中华内科杂志

ABSTRACT

Objective To investigate the clinical characteristics of multiple endocrine neoplasia type 1(MEN1)patients presenting with hypoglycemic coma as chief manifestation and the related clinical experience in diagnosis and therapy.Methods We analyzed the clinical data of 4 patients who were hospitMized because of recurrent hypoglycemic coma and diagnosed as having MEN1 by endocrinolgical,radiological and pathological examinations.Results In the 4 cases of Whipple trilogy,radiological examination showed occupying lesion in the pancreas and pathological examination confirmed the diagnosis of insulinoma.In 2 cases the insulinomas were multiple.In this series,one cage was complicated with pituitary adenoma,parathyroidoma(recurrent after operation)and adrenocortical adenoma,one case with pituitary adenoma,parathyroidoma(2 tumors)and adrenal nodular hyperplasia,one case with pituitary adenoma and parathyroidoma,and the remaining one with pituitary adenoma and suspectable parathyroidoma.Conclusions For patients with insulinoma,MEN1 should be considered.In patients with MEN1,the presence of multiple or ectopic Darathymid adenomas(or hyperplasia)and insulinomas should be inspected during operation.After operation,examinations should be regularly performed to identify whether the diseases relapse or new endocrine neoplasias occur.