system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 56-year-old man comes to the clinic complaining of intermittent abdominal pain for the past 2 months. He reports that the pain improves with oral intake and is concentrated at the epigastric area. The pain is described as gnawing in quality and improves when he takes his wife’s ranitidine. He denies weight changes, fever, chest pain, or recent travel but endorses “brain fog” and decreased libido. An upper endoscopy reveals ulcerations at the duodenum and jejunum. Physical examination demonstrates bilateral hemianopsia, gynecomastia, and diffuse pain upon palpation at the epigastric area. Laboratory findings are demonstrated below:

Serum:
Na+: 137 mEq/dL
Cl-: 96 mEq/L
K+: 3.9 mEq/dL
HCO3-: 25 mEq/L
Glucose: 110 mg/dL
Creatinine: .7 mg/dL
Ca2+: 13.5 mg/dL

What is the best explanation for this patient’s findings?
assistant
Mutation of the MEN1 gene