Cited by 121Pancreatic function and diabetesNeuroendocrine Tumor Research AdvancesPancreatitis Pathology and Treatment

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Noninsulinoma pancreatogenous hypoglycemia syndrome: An update in 10 surgically treated patients

Thompson, Geoffrey B., Service, F.John, Andrews, James C., Lloyd, Ricardo V., Natt, Neena, van Heerden, Jon A., Grant, Clive S.·2000·Surgery

DOI 10.1067/msy.2000.110243

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Abstract

Background Neuroglycopenia from endogenous hyperinsulinism usually is caused by insulinomas in adults. We recently reported a novel hypoglycemic disorder in 5 patients (patients 1 to 5) with postprandial neuroglycopenia, negative 72-hour fasts, negative perioperative imaging studies, but positive calcium stimulation tests and islet hypertrophy and nesidioblastosis in the gradient-guided resected pancreata. Methods In this report we compare our experience with 5 additional patients (patients 6 to 10) with this syndrome to that in the original report. Results The clinical features of patients 6 to 10 were similar to those of patients 1 to 5. Each had positive calcium stimulation testing that guided the extent of the distal pancreatectomy and histologic evidence of islet cell hypertrophy or nesidioblastosis. All 10 patients are alive from 9 to 50 months after operation, 1 of whom had no amelioration of neuroglycopenia. Minor perioperative complications occurred in 3 patients. One patient has experienced repeated bouts of acute pancreatitis, pseudocyst formation, and exocrine insufficiency. Conclusions We have identified adult patients with severe, postprandial hyperinsulinemic hypoglycemia from diffuse islet cell disease, 80% of whom have been well palliated with surgery. The results in 7 men have been better than those in the 3 women for reasons that are not obvious.

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Authors: Thompson, G. B., Service, F. J., Andrews, J. C., Lloyd, R. V., Natt, N., van Heerden, J. A., & Grant, C. S.
Affiliations: Mayo Clinic (US)
ORCID: Thompson, Geoffrey B.
Andrews, James C.
Venue: Surgery
Publisher: Elsevier BV
Published: 2000-12
Volume: 128
Issue: 6
Pages: 937-945
ISSN: 0039-6060 (ISSN-L)
DOI: 10.1067/msy.2000.110243
OpenAlex: W2087465249
Cited by: 121
References: 23
Citations by year: 2026: 3 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 4 · 2013: 3 · 2012: 8
FWCI: 1.80
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Keywords: hyperinsulinemic hypoglycemia, nesidioblastosis, calcium stimulation test, distal pancreatectomy, surgical outcomes, sex differences in outcomes
MeSH terms: Adolescent, Adult, Aged, Calcium, Female, Humans, Hypoglycemia, Male, Middle Aged, Pancreatectomy, Postoperative Complications, Syndrome

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Noninsulinoma pancreatogenous hypoglycemia syndrome: An update in 10 surgically treated patients

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