Multiple endocrine neoplasia (MEN) type I is also known as Wermer syndrome.
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Primary hyperparathyroidism is one of the commonest presentations.
Abnormality is related to a tumour suppressor gene located in chromosome 11q13. MEN type I is an autosomal dominant syndrome characterised by:
- pituitary adenomas: 30% of patients, most frequently prolactinomas
- islet cell tumours of the pancreas: 50% of patients, and a major cause of mortality, most often gastrinomas followed by glucogonomas
- parathyroid hyperplasia: with resulting hyperparathyroidism seen in 80-95% of patients
Handy mnemonics for recalling MEN type I:
- PPP or PiParPanc
- adrenal cortical lesions
- carcinoid tumours
- hepatic focal nodular hyperplasia 5
- Zollinger-Ellison syndrome 6
History and etymology
It was first characterised by P Wermer et al. in 1954 3.
Treatment and prognosis
Pancreatic malignancy is the leading cause of mortality in MEN type I.
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- 6. Gibril F, Schumann M, Pace A et-al. Multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome: a prospective study of 107 cases and comparison with 1009 cases from the literature. Medicine (Baltimore). 2004;83 (1): 43-83. doi:10.1097/01.md.0000112297.72510.32 - Pubmed citation