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RESOLUTION OF HYPERGASTRINAEMIA AFTER PARATHYROIDECTOMY IN MULTIPLE ENDOCRINE NEOPLASIA SYNDROME TYPE I (MEN TYPE I)
Author(s) -
MACLEOD A. F.,
AYERS B.,
YOUNG A. E.,
MEDD W. E.,
SÖNKSEN P. H.
Publication year - 1987
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1987.tb00827.x
Subject(s) - endocrinology , medicine , parathyroidectomy , hypercalcaemia , gastrin , multiple endocrine neoplasia , secretin , endocrine system , gastric acid , parathyroid hormone , hormone , stomach , biology , calcium , secretion , gene , biochemistry
SUMMARY The treatment of choice for gastric acid hypersecretion in MEN type I has now changed from total gastrectomy to the long‐term administration of H 2 receptor blockers or similar agents. However, the importance of parathyroidectomy for the concomitant hypercalcaemia is not fully realized. A case is reported of a subject with MEN type I, who was initially treated with parathyroidectomy and H 2 receptor blockade. Following parathyroidectomy, there was a rapid fall of the markedly elevated gastrin levels to the upper limit of the normal range. During follow‐up of 2–5 years, there has been no increase in serum gastrin, and the subject's gastric symptoms have resolved, despite the cessation of H2 blockade. Infusion of calcium to pre‐operative levels and superimposed secretin stimulation after this period of time closely reproduced the pre‐operative hypergastrinaemia. On screening, the subject's only child was found to have hypercalcaemia but normal serum gastrin levels and pituitary function; parathyroidectomy has been carried out. No abnormality of gastrin secretion has been found during follow‐up. This case highlights the importance of early parathyroidectomy in this syndrome.