MULTIPLE ENDOCRINE NEOPLASIA

Multiple endocrine neoplasia, type 1 (MEN 1), sometimes called Wermer's syndrome, is a rare disorder that causes tumors in the endocrine glands and parts of the small intestine and stomach. In MEN 1, the endocrine glands — usually the parathyroids, pancreas and pituitary — grow tumors and release excessive amounts of hormones that can lead to disease. However, the tumors are usually noncancerous (benign) .The excess hormones can cause a wide variety of signs and symptoms. These can include tiredness, bone pain, broken bones, kidney stones, and ulcers in the stomach or intestines.

MEN1 gene provides instructions for making a protein called menin. This protein acts as a tumor suppressor, which means that it keeps cells from growing and dividing too fast or in an uncontrolled way. Although the exact function of menin is unclear, it is likely involved in several important cell functions.

CLINICAL FEATURES:

HYPERPARATHYROIDISM - MOST COMMON

constipation, anorexia, nausea and vomiting, abdominal pain, and ileus. Impairment of the renal concentrating mechanism leads to polyuria, nocturia, and polydipsia. Elevation of serum calcium > 12 mg/dL (> 3.00 mmol/L) can cause emotional lability, confusion, delirium, psychosis, stupor, and coma. Hypercalcemia may cause neuromuscular symptoms, including skeletal muscle weakness. Hypercalciuria with nephrolithiasis is common

ENTEROPANCREATIC TUMORS -

Medullary thyroid carcinoma

Pheochromocytomas

Mucosal neuromas

Marfanoid .

DIAGNOSIS:

• Parathyroid hormoneand calcium (and ionized calcium) to detect hyperparathyroidism (often the first sign of MEN 1).
• Prolactinis a hormone commonly over-produced by the pituitary gland.
• Gastrincauses stomach ulcers and is produced by overactivity in the region of the pancreas. Gastrinomas are the most common neuroendocrine tumor of the pancreas which occurs with MEN 1. Although the pancreas can have endocrine tumors of insulin secreting cells or other hormones, gastrin is the most common.
• Tumor localization with MRI, CT, ultrasonography, or 18F-FDG PET/CT

HOMOEOPATHIC MANAGEMENT:

THUJA - Acts on skin, blood, gastro-intestinal tract, kidneys, and brain. Its relation to the production of pathological vegetations condylomate, warty excrescences, spongy tumors is very important, when walking, limbs feel as if made of wood or glass, and would break easily. Tips of fingers swollen, red, feel read. Muscular twitchings, weakness and trembling. Cracking in joints.

SULPHUR- AS A CONSTITUTIONAL REMEDY

IODUM- Rapid metabolism: Loss of flesh great appetite. Hungry with much thirst. Better after eating. Great debility, the slightest effort induces perspiration. Iod individual is exceedingly thin, dark complexioned, with enlarged lymphatic glands, has voracious appetite but gets thin. Tubercular type, Cold hands and feet. Acrid sweat of feet. Pulsation in large arterial trunks. Rheumatic pains, nightly pains in joints; constrictive sensations.

Calcarea Carbonica: this is very good for calcium deficiency in hypoparathyroidism and osteoporosis in hyperthyroidism (which is a weakness of the bones due to loss of parts of the bones).

Calcarea Phosphorica:. It helps balance the calcium and phosphorus levels in the body. The concentration at which the homeopathic doctor will give you will depend on your circumstances and whether it is hyperparathyroidism or hypoparathyroidism. It is also useful for nausea, vomiting, tetany, bone disorders and a host of other symptoms in parathyroid disease. There is a case study of a woman with primary hyperparathyroidism which came with vomiting and extreme weakness who was treated with Calcarea Phosphoric 200C and improved dramatically after continuous treatment.

Nux Vomica: This plant-based drug is very effective for nausea and vomiting in parathyroid disorders.

Magnesia Phosphorica: this homeopathic remedy is very good in treating tetany which is common in hypoparathyroidism.

Symphytum Officinale: used to treat bone fractures and other bone complications due to osteoporosis.

Fluoricum Acidum: this is used for bone disorders, especially when it is caused by metabolic disorders – like parathyroid disorders for instance.