A 40-year-old woman with a history of hyperparathyroidism presents with a 2-month history of burning epigastric pain. The pain can be relieved with antacids or food. The patient also repos a recent history of tarry stools. She denies taking aspirin or NSAIDs. Laboratory studies show a microcytic, hypochromic anemia . Gastroscopy reveals a bleeding mucosal defect in the antrum. Which of the following best characterizes the pathogenesis of epigastric pain in this patient?
Decreased Calcium resorption by renal tubules
Decreased serum levels of PTH
Gastric nonresponsiveness to PTH
Increased secretion of Gastrin
- Given clinical features point towards Peptic ulcer disease, secondary to hyper-parathyroidism. - Incidence of peptic ulcer disease is increased in patients with hyperparathyroidism, because hypercalcemia increases serum gastrin, thereby stimulating gastric acid secretion. - None of the other choices are associated with gastric ulcers. - Peptic ulcers in context of MEN-1 may be secondary to Zollinger Ellison syndrome
Parathyroids