A 40-Year-Old Man Comes to the Office Due to Recurrent

A 40-year-old man comes to the office due to recurrent epigastric abdominal pain, nausea, and watery diarrhea for the past several months.  The patient has had similar burning pain previously and was treated for peptic ulcer disease.  He has been taking over-the-counter antacids but with no significant symptom relief.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  Abdominal examination shows mild epigastric tenderness and increased bowel sounds.  Testing for stool occult blood is positive, and laboratory studies show microcytic hypochromic anemia.  Serum gastrin level is markedly elevated.  Upper gastrointestinal endoscopy reveals prominent gastric folds and multiple ulcers in the duodenum and proximal jejunum.  Given these findings, this patient should be assessed for a personal or family history of which of the following conditions?

A) Cerebellar hemangioblastomas
B) Mucosal neuromas
C) Plexiform neurofibromas
D) Recurrent nephrolithiasis
E) Thyroid malignancy

Correct Answer:

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