Algorithm for Screening and Management in Multiple Endocrine Neoplasia Type 1 (MEN1) Syndromes - Flowchart
Algorithm for Screening and Management in Multiple Endocrine Neoplasia Type 1 (MEN1) Syndromes - Flowchart Multiple Endocrine Neoplasia Multiple Endocrine Neoplasia
«Flowchart»

Algorithm for biochemical and radiographic diagnosis/surveillance in men1 patients

Algorithm for biochemical and radiographic diagnosis/surveillance in men1 patients

Algorithm for biochemical and radiographic diagnosis/surveillance in men1 patients

No further screening

No further screening

No further screening

Genetic testing

Genetic testing

Genetic testing

Positive

Positive

Positive

Negative

Negative

Negative

End

End

End

MRI

MRI

MRI

Continue annually

Continue annually

Continue annually

Age 5: Begin yearly pituitary screening (prolactin level)

Age 5: Begin yearly pituitary screening (prolactin level)

Age 5: Begin yearly pituitary screening (prolactin level)

Elevated

Elevated

Elevated

Age 8: Begin yearly parathyroid screening (calcium and PTH levels)

Age 8: Begin yearly parathyroid screening (calcium and PTH levels)

Age 8: Begin yearly parathyroid screening

Normal

Normal

Normal

Sestamibi scan, ultrasound

Sestamibi scan, ultrasound

Sestamibi scan, ultrasound

Elevated Ca and PTH

Elevated Ca and PTH

Elevated Ca and PTH

Age 20: Begin yearly pancreas screening (gastrin, chromogranin A, proinsulin, glucagon, and CT/MRI)

Age 20: Begin yearly pancreas screening (gastrin, chromogranin A, proinsulin, glucagon, and CT/MRI)

Age 20: Begin yearly pancreas screening

Normal

Normal

Normal

Observed fast

Observed fast

Observed fast

SRS, EUS

SRS, EUS

SRS, EUS

Elevated gastrin, chromogranin A, glucagon

Elevated gastrin, chromogranin A, glucagon

Elevated gastrin, chromogranin A, glucagon

Elevated proinsulin

Elevated proinsulin

Elevated proinsulin

CT/MRI-identified abnormality

CT/MRI-identified abnormality

CT/MRI-identified abnormality

Normal

Normal

Normal