Hyperparathyroidism in the context of multiple endocrine neoplastic syndromes

Abstract

Background. Multiple endocrine neoplastic syndromes (Multiple Endocrine Neoplasia - MEN) are a group of disorders characterized by simultaneous or successive association of hyperplastic or tumoral lesions, usually benign or malignant, usually hypersecretory, at least involving two endocrine glands, without obvious functional interrelations. MEN 1 is one of the three distinct types of MEN that affect the parathyroid glands, endocrine pancreas and anterior pituitary gland. Parathyroid glands are the first and most commonly affected by MEN 1 (95%). The diagnosis can be established before the age of 20 by identifying some suggestive signs – recurrent urinary lithiasis, muscle or bone pain. All patients with MEN should be registered and supervised throughout life, given that the tumors remain asymptomatic for a long time. Case report. Patient X, age 48, has been suffering for approximately 20 years for kidney stones. Was operated on parathyroid, then had consecutive surgeries on the kidneys, and in 2015 started the treatment with hemodialysis. In the meantime, hyperprolactinemia has been identified, and pituitary adenoma has been described on MRI. For the moment, the Patient X is on a complex pathogenic treatment. Conclusions. 1. Parathyroid adenoma is commonly found in polyglandular neoplastic syndromes. 2. Hyperparathyroidism once diagnosed, it is necessary to differentiate primary, secondary or tertiary type in order to establish prompt treatment tactics and to prevent complications. 3. The complex approach of the patient with hyperparathyroidism is essential.