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MEN1 — SCE Endocrinology MCQ

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ModerateNET/MENMEN1SCE Endocrinology

A 45-year-old man has recurrent peptic ulceration and diarrhoea. Fasting gastrin is markedly raised despite gastric pH 1.5. Calcium is 2.84 mmol/L with raised PTH. What is the most likely diagnosis?

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Correct answer: A — MEN1 with gastrinoma and primary hyperparathyroidism

Gastrinoma with acidic stomach and primary hyperparathyroidism strongly suggests MEN1. MEN2A is associated with medullary thyroid carcinoma and phaeochromocytoma rather than gastrinoma. Hypercalcaemia can worsen gastrin secretion and ulcer disease.

Reference: Endocrine Society MEN1 Guidance