UNVEILING MULTIPLE ENDOCRINE NEOPLASIA TYPE 1 (MEN-1) IN A YOUNG PAKISTANI MALE WITH RECURRENT HYPOGLYCEMIA: A DIAGNOSTIC ODYSSEY IN A RESOURCE-LIMITED SETTING

Zoha Rehman, Noshaba Razaq, Wajahat Sultan Baig, Amara Anees, Zunaira Abbas, Zavata Afnan, Hamna Khalid, Hamna Nasir

Turkish Journal of Internal Medicine - 2025;7(4):141-146

Department of Internal Medicine, Wah Medical College, Pof Hospital Wahcantt, Pakistan

 

This case report describes a 32-year-old Pakistani male who was initially admitted to a tertiary care hospital with Typhoid fever, but later developed recurrent life-threatening hypoglycemia. Extensive investigations revealed elevated insulin and C-peptide levels, a pituitary microadenoma, and a somatostatin-avid gastric lesion, leading to the diagnosis of Multiple Endocrine Neoplasia type 1 (MEN-1). Management included dextrose infusions, somatostatin-analogue therapy, and supportive care. The case highlights the diagnostic challenges of MEN-1 in atypical presentations and resource-limited settings, and underscores the need for a multidisciplinary approach to treatment and psychosocial support.