Multiple endocrine neoplasia type 1 differential diagnosis: Difference between revisions
Aditya Ganti (talk | contribs) |
Aditya Ganti (talk | contribs) |
||
Line 37: | Line 37: | ||
| + | | + | ||
| | | | ||
* Clinical diagnosis | |||
* In hereditary VHL, disease techniques such as Southern blotting and gene sequencing can be used to analyse DNA and identify mutations. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Carney complex]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Carney complex]] | ||
Line 49: | Line 52: | ||
| - | | - | ||
| | | | ||
* Clinical diagnosis | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Neurofibromatosis type 1]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Neurofibromatosis type 1]] | ||
Line 62: | Line 66: | ||
| - | | - | ||
| - | | - | ||
| | |'''<u>Prenatal</u>''' | ||
* Chorionic villus sampling or amniocentesis can be used to detect NF-1 in the fetus. | |||
'''<u>Postnatal</u>''' | |||
Cardinal Clinical Features" are required for positive diagnosis. | |||
* Six or more café-au-lait spots over 5 mm in greatest diameter in pre-pubertal individuals and over 15 mm in greatest diameter in post-pubertal individuals. | |||
* Two or more neurofibromas of any type or 1 plexiform neurofibroma | |||
* Freckling in the axillary (Crowe sign) or inguinal regions | |||
* Optic glioma | |||
* Two or more Lisch nodules (pigmented iris hamartomas) | |||
* A distinctive osseous lesion such as sphenoid dysplasia, or thinning of the long bone cortex with or without pseudarthrosis. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Li-Fraumeni syndrome]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Li-Fraumeni syndrome]] | ||
Line 77: | Line 92: | ||
| - | | - | ||
| | | | ||
'''<u>Criteria</u>''' | |||
* Sarcoma at a young age (below 45) | |||
* A first-degree relative diagnosed with any cancer at a young age (below 45) | |||
* A first or second degree relative with any cancer diagnosed before age 60. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Gardner's syndrome]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Gardner's syndrome]] | ||
Line 92: | Line 112: | ||
| - | | - | ||
| | | | ||
* Clinical diagnosis | |||
* Colonoscopy | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Multiple endocrine neoplasia type 2]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Multiple endocrine neoplasia type 2]] | ||
Line 104: | Line 127: | ||
| - | | - | ||
| | | | ||
* [[Hypercalcemia]] | |||
* [[Hypophosphatemia]], | |||
* Elevated [[parathyroid hormone]], | |||
* Elevated [[norepinephrine]] | |||
'''<u>Criteria</u>''' | |||
Two or more specific endocrine tumors | |||
* [[medullary thyroid carcinoma]] | |||
* [[pheochromocytoma]] | |||
* [[parathyroid]] hyperplasia | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Cowden syndrome]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Cowden syndrome]] | ||
Line 113: | Line 149: | ||
| - | | - | ||
| | | | ||
* ''PTEN'' mutation probability risk calculator | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Acromegaly]]/[[gigantism]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Acromegaly]]/[[gigantism]] | ||
Line 127: | Line 164: | ||
|<nowiki>-</nowiki> | |<nowiki>-</nowiki> | ||
| | | | ||
* An elevated concentration of serum [[Growth hormone|growth hormone (GH)]] and [[Insulin-like growth factor|insulin-like growth factor 1(IGF-1)]] levels is diagnostic of acromegaly. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pituitary adenoma]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pituitary adenoma]] | ||
Line 140: | Line 178: | ||
| | | | ||
| | | | ||
:*Elevated serum level of [[prolactin]] | |||
:*Elevated or decreased serum level of [[adrenocorticotropic hormone]] (ACTH) | |||
:*Elevated or decreased serum level of [[growth hormone]] (GH) | |||
:*Elevated or decreased serum level of [[thyroid-stimulating hormone]] (TSH) | |||
:*Elevated or decreased serum level of [[follicle-stimulating hormone]] (FSH) | |||
:*Elevated or decreased serum level of [[luteinizing hormone]] (LH) | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Hyperparathyroidism]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Hyperparathyroidism]] | ||
Line 151: | Line 195: | ||
* [[depression]] | * [[depression]] | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>-</nowiki> | |||
|<nowiki>-</nowiki> | |||
| | | | ||
* An elevated concentration of serum [[calcium]] with elevated [[parathyroid hormone]] level is diagnostic of primary hyperparathyroidism. | |||
| | * Most consistent laboratory findings associated with the diagnosis of secondary hyperparathyroidism include elevated serum [[parathyroid hormone]] level and low to normal serum [[calcium]]. | ||
* An elevated concentration of serum [[calcium]] with elevated [[parathyroid hormone]] level in post [[Kidney transplantation|renal transplant]] patients is diagnostic of tertiary hyperparathyoidism. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pheochromocytoma]]/[[paraganglioma]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pheochromocytoma]]/[[paraganglioma]] | ||
Line 177: | Line 224: | ||
| | | | ||
* Increased catecholamines and metanephrines in plasma (blood) or through a 24-hour urine collection. | * Increased catecholamines and metanephrines in plasma (blood) or through a 24-hour urine collection. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Adrenocortical carcinoma]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Adrenocortical carcinoma]] | ||
Line 197: | Line 243: | ||
|<nowiki>-</nowiki> | |<nowiki>-</nowiki> | ||
| | | | ||
* | * Increased serum glucose | ||
* | * Increased urine cortisol | ||
* | * Serum androstenedione and dehydroepiandrosterone | ||
* | * Low serum potassium | ||
* | * Low plasma renin activity | ||
* | * High serum aldosterone. | ||
* | * Excess serum estrogen. | ||
|- | |- | ||
| colspan="8" style="padding: 5px 5px; background: #F5F5F5;" |<small>Adapted from Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts, journal=Clinics (Sao Paulo), volume= 68, issue= 7, 07/24/2013<ref name="pmid23917672">{{cite journal| author=Toledo SP, Lourenço DM, Toledo RA| title=A differential diagnosis of inherited endocrine tumors and their tumor counterparts. | journal=Clinics (Sao Paulo) | year= 2013 | volume= 68 | issue= 7 | pages= 1039-56 | pmid=23917672 | doi=10.6061/clinics/2013(07)24 | pmc=PMC3715026 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23917672 }} </ref> </small> | | colspan="8" style="padding: 5px 5px; background: #F5F5F5;" |<small>Adapted from Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts, journal=Clinics (Sao Paulo), volume= 68, issue= 7, 07/24/2013<ref name="pmid23917672">{{cite journal| author=Toledo SP, Lourenço DM, Toledo RA| title=A differential diagnosis of inherited endocrine tumors and their tumor counterparts. | journal=Clinics (Sao Paulo) | year= 2013 | volume= 68 | issue= 7 | pages= 1039-56 | pmid=23917672 | doi=10.6061/clinics/2013(07)24 | pmc=PMC3715026 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23917672 }} </ref> </small> |
Revision as of 16:45, 17 October 2017
Multiple endocrine neoplasia type 1 Microchapters |
Differentiating Multiple endocrine neoplasia type 1 from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Multiple endocrine neoplasia type 1 differential diagnosis On the Web |
American Roentgen Ray Society Images of Multiple endocrine neoplasia type 1 differential diagnosis |
FDA on Multiple endocrine neoplasia type 1 differential diagnosis |
CDC on Multiple endocrine neoplasia type 1 differential diagnosis |
Multiple endocrine neoplasia type 1 differential diagnosis in the news |
Blogs on Multiple endocrine neoplasia type 1 differential diagnosis |
Directions to Hospitals Treating Multiple endocrine neoplasia type 1 |
Risk calculators and risk factors for Multiple endocrine neoplasia type 1 differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Multiple endocrine neoplasia type 1 must be differentiated from other hereditary diseases such as von Hippel-Lindau syndrome, tuberous sclerosis, carney complex, neurofibromatosis type 1, Li-Fraumeni syndrome, multiple endocrine neoplasia type 2, familial hyperparathyroidism, pheochromocytoma and acromegaly.
Differential Diagnosis
Multiple endocrine neoplasia type 1 must be differentiated from the hereditary diseases shown in the table below.
Disease | Gene | Chromosome | Differentiating Features | Components of MEN | Diagnosis | ||
---|---|---|---|---|---|---|---|
Parathyroid | Pitutary | Pancreas | |||||
von Hippel-Lindau syndrome | Von Hippel–Lindau tumor suppressor | 3p25.3 |
|
+ |
| ||
Carney complex | PRKAR1A | 17q23-q24 |
|
- | - | - |
|
Neurofibromatosis type 1 | RAS | 17 | - | - | - | Prenatal
Postnatal Cardinal Clinical Features" are required for positive diagnosis.
| |
Li-Fraumeni syndrome | TP53 | 17 | Early onset of diverse amount of cancers such as | - | - | - |
Criteria
|
Gardner's syndrome | APC | 5q21 |
|
- | - | - |
|
Multiple endocrine neoplasia type 2 | RET |
|
+ | - | - |
Criteria Two or more specific endocrine tumors
| |
Cowden syndrome | PTEN | Hamartomas, | - | - | - |
| |
Acromegaly/gigantism |
|
- | + | - |
| ||
Pituitary adenoma |
|
+ |
| ||||
Hyperparathyroidism | + | - | - |
| |||
Pheochromocytoma/paraganglioma | VHL
RET NF1 SDHB SDHD |
Characterized by | - | - | - |
| |
Adrenocortical carcinoma | p53
Retinoblastoma h19 insulin-like growth factor II (IGF-II) p57kip2 |
17p, 13q |
|
- | - | - |
|
Adapted from Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts, journal=Clinics (Sao Paulo), volume= 68, issue= 7, 07/24/2013[1] |
References
- ↑ Toledo SP, Lourenço DM, Toledo RA (2013). "A differential diagnosis of inherited endocrine tumors and their tumor counterparts". Clinics (Sao Paulo). 68 (7): 1039–56. doi:10.6061/clinics/2013(07)24. PMC 3715026. PMID 23917672.