![]() Presence of insulinoma, primary hyperparathyroidism and pituitary microadenoma, in 3 rd decade of life with characteristic cutaneous tumours was suggestive of a clinical diagnosis of MEN 1 syndrome. Hypercalcemia with elevated parathyroid hormone level suggested a parathyroid adenoma. Laboratory evaluation confirmed endogenous hyperinsulinaemic hypoglycaemia suggestive of an insulinoma. Rest of the clinical examination was normal. Tendon reflexes were exaggerated with up going planter reflexes. Pupils were sluggishly reactive to light. Multiple cutaneous collagenomas were noted on anterior chest and abdominal wall. Her Body mass index(BMI) was 32 kg/m 2.She had signs of hyperandrogenism. There was no fever, seizures or symptoms suggestive of meningism. There was recent increase in appetite with significant weight gain. It was preceded by fluctuating, hallucinatory behavior for two weeks duration. Case presentationĪ 23-year-old female, previously diagnosed with Polycystic Ovarian Syndrome (PCOS) and pituitary microprolactinoma presented with drowsiness,confusion and profuse sweating developing over a period of one day. Diagnosis and management of MEN 1 syndrome is challenging due to its vast heterogeneity in clinical presentation. Multiple endocrine neoplasia type 1 (MEN 1) syndrome is a rare, complex genetic disorder characterized by increased predisposition to tumorigenesis in multiple endocrine and non-endocrine tissues. ![]()
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