Abstract
A case of hyperparathyroidism complicated by pancreatic stones and diabetes mellitus is reported.
At the age of 28, the patient began to have epigastralgia frequently and pancreatic stones were pointed out at a local hospital.At the age of 30, he was first admitted to our hospital because of repeated attacks of epigastralgia.The diagnosis was hyperparathyroidism, pancreatic stones and hypopituitarism.He underwent parathyroidectomy.Microscopic examination showed hyperplasia of the parathyroid.Therefore his disease was diagnosed as multiple endocrine adenomatosis (MEA) Type 1.Six months before his second admission, thirst and weightloss started and diabetes was diagnosed.
On the second admission, hemoglobin A1 was 15.4%, postprandial blood glucose showed hyperglycemia, and the insulin level was low.He had no diabetic microangiopathy.Pancreatic exocrine function and plasma PTH level were normal.In a pituitary function test, GH was low but ACTH, prolactin, TSH, LH and FSH were within normal range.On an X-ray of the skull, the pituitary fossa showed slight enlargement and X-ray of the abdomen clearlyshowed numerous pancreatic stones.The hyperglycemia was controlled by diet and insulin therapy (Monotard insulin 6 units).
