MEN1 PATIENTS FOLLOW UP

1. Periodic routine biochemical screening for adults with proven MEN 1
At least annually, fasting blood sample for:
Ionized Ca and albumin corrected Ca, PTH
Gastrin, glycoprotein alpha subunit
Glucagon, VIP, PP, chromogranin A
Prolactin, IGF-1, TSH, FT4
Glucose and insulin
Cholesterol, triglycerides and HDL
U&E, LFTs
2. Periodic routine imaging screening for adults with proven MEN 1
Annual abdominal ultrasonography-examining pancreas, liver and adrenals.
Third–fifth yearly CT or MRI of chest and abdomen for bronchopulmonary carcinoid, thymic carcinoid, adrenal and gastroenteropancreatic tumours
Third to fifth yearly pituitary MRI
Fifth yearly DXA BMD
3. General considerations
Depending on other clinical and familial factors and diagnoses, including symptoms, immediate family history and previous biochemical or radiological findings, the above protocol is modified for individual patient requirements. Children and adolescents without symptomatic disease generally undergo counselling for genetic testing at 10–12 years age, and if disease inheritance is confirmed, limited biochemical and nonionizing radiation imaging to identify presymptomatic hyperparathyroidism and pituitary disease.