[Multiple endocrine neoplasia type 1 presenting as hypoglycemic coma: a report of four cases and review of literatures].
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 hospitalized because of recurrent hypoglycemic coma and diagnosed as having MEN1 by endocrinological, 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 case 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 suspectible parathyroidoma.


CONCLUSIONS
For patients with insulinoma, MEN1 should be considered. In patients with MEN1, the presence of multiple or ectopic parathyroid 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.
Wang
Xian-ling
XL
Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
Lu
Ju-ming
JM
Dou
Jing-tao
JT
Mu
Yi-ming
YM
Lü
Zhao-hui
ZH
Guo
Qing-hua
QH
Ba
Jian-ming
JM
Pan
Chang-yu
CY
D000328:Adult; D003128:Coma / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications* / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis; D055815:Young Adult