Hypoglycaemia in an adult male: A surprising finding in pursuit of insulinoma
Abstract
A 50-year-old man who had suffered several episodes of early morning sweats and tremors was diagnosed as having hyperinsulinaemic hypoglycaemia. Cross-sectional imaging and endoscopic ultrasound revealed no pancreatic lesion. A selective intra-arterial calcium infusion study showed a two-fold increase of insulin secretion after infusion of the splenic and superior mesenteric arteries. Laparotomy was performed, no lesion was identified after full mobilisation of the pancreas, and nothing was evident with intra-operative ultrasound. A distal pancreatectomy was performed. Microscopically, the pancreas exhibited diffuse islet cell hyperplasia consistent with nesidioblastosis. The patient remains euglycaemic eight months post-operatively.
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This symptom finally led to the correct diagnosis of a functional β-cell disorder, also known as diffuse adult-onset nesidioblastosis or NIPHS.
“This symptom finally led to the correct diagnosis of a functional β -cell disorder, also known as diffuse adult-onset nesidioblastosis or non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS) [4-6].”
Hypoglycemia in the non-diabetic adult patient needs a thorough clinical and laboratory work-up.
“Hypoglycemia in the non-diabetic adult patient needs a thorough clinical and laboratory work-up [4].”
Cites
Anlauf, M., Wieben, D., Perren, A., Sipos, B., Komminoth, P., Raffel, A., Kruse, M. L., Fottner, C., Knoefel, W. T., Mönig, H., et al. (2005) · American Journal of Surgical Pathology · doi:10.1097/01.pas.0000151617.14598.ae · Cited by 167 · see citing works
Noninsulinoma pancreatogenous hypoglycemia syndrome: An update in 10 surgically treated patients
Thompson, G. B., Service, F. J., Andrews, J. C., Lloyd, R. V., Natt, N., van Heerden, J. A., & Grant, C. S. (2000) · Surgery · doi:10.1067/msy.2000.110243 · Cited by 121 · see citing works
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Dieterle, M. P., Husari, A., Prozmann, S. N., Wiethoff, H., Stenzinger, A., Röhrich, M., Pfeiffer, U., Kießling, W. R., Engel, H., Sourij, H., et al. (2023) · Biomedicines · doi:10.3390/biomedicines11061741 · Cited by 5 · see citing works
“Hypoglycemia in the non-diabetic adult patient needs a thorough clinical and laboratory work-up [4].”
Background
- Authors
- Geraghty, M., Draman, M., Moran, D., Muldoon, C., Reynolds, J. V., & Cullen, M. J.
- Affiliations
- St. James's Hospital (IE)
- Venue
- The Surgeon
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 6
- Issue
- 1
- Pages
- 57-60
- ISSN
- 1479-666X (ISSN-L)
- OpenAlex
- W2057350823
- Cited by
- 6
- References
- 2
- Citations by year
- 2024: 1 · 2023: 3 · 2017: 1
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Surgeon (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Keywords
- hypoglycemia, insulinoma, hyperinsulinemic hypoglycemia, nesidioblastosis, pancreatic islet cell hyperplasia, distal pancreatectomy, endoscopic ultrasound, intraoperative ultrasound, normoglycemia
- MeSH terms
- Diagnosis, Differential, Humans, Hyperinsulinism, Hypoglycemia, Insulinoma, Magnetic Resonance Imaging, Male, Middle Aged, Pancreatic Neoplasms, Tomography, X-Ray Computed, Ultrasonography, Interventional, Endosonography, Nesidioblastosis
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