title: Gestational diabetes leading to diagnosis and management of multiple endocrine neoplasia type 2a.
abstract: BACKGROUND
  Multiple endocrine neoplasia (MEN) type 2a is an autosomal dominant syndrome caused by specific proto-oncogene mutations characterized by medullary carcinoma of the thyroid, pheochromocytoma, and, occasionally, multiglandular parathyroid hyperplasia, which rarely complicates pregnancy. Secondary diabetes rarely has been reported in association with principal endocrinopathies complicating pregnancy.
  
  
  METHODS
  A 34-year-old primiparous woman with recently diagnosed gestational diabetes had repeated episodes of dizziness at 30 weeks of gestation, initially attributed to glyburide. Continued episodes of dizziness and later-appearing bouts of severe headache, palpitations, diaphoresis, severe hypertension, and marked tachycardia led to diagnosis and management of MEN type 2a complicating pregnancy.
  
  
  CONCLUSIONS
  Patients with MEN type 2a complicating pregnancy may present with gestational diabetes.
authors.affiliation: From the Divisions of Maternal-Fetal Medicine and Gynecologic Oncology and the Departments of Obstetrics and Gynecology and Radiology, State University of New York, Downstate Medical Center, Brooklyn, New York.
authors.forename: David M
authors.initials: DM
authors.lastname: Sherer
authors.forename: Mudar
authors.initials: M
authors.lastname: Dalloul
authors.forename: Ghadir
authors.initials: G
authors.lastname: Salame
authors.forename: Puja
authors.initials: P
authors.lastname: Kalidas
authors.forename: Harry L
authors.initials: HL
authors.lastname: Zinn
authors.forename: Ovadia
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000209:etiology*; D005260:Female; D006801:Humans; D018813:Multiple Endocrine Neoplasia Type 2a / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000628:therapy; D000090063:Proto-Oncogene Mas