Adult hyperinsulinemic hypoglycemia not caused by an insulinoma: a report of two cases

被引：0

作者：

B. C. H. van der Wal

R. R. de Krijger

W. W. de Herder

D. J. Kwekkeboom

F. van der Ham

H. J. Bonjer

C. H. J. van Eijck

机构：

[1] Department of Surgery,

[2] Erasmus University Hospital,undefined

[3] Rotterdam,undefined

[4] The Netherlands,undefined

[5] Department of Pathology,undefined

[6] Erasmus University Hospital,undefined

[7] Rotterdam,undefined

[8] The Netherlands,undefined

[9] Department of Internal Medicine,undefined

[10] Erasmus University Hospital,undefined

[11] Rotterdam,undefined

[12] The Netherlands,undefined

[13] Department of Nuclear Medicine,undefined

[14] Erasmus University Hospital,undefined

[15] Rotterdam,undefined

[16] The Netherlands,undefined

[17] Uiterwaardenstraat 394 hs,undefined

[18] 1079 DE Amsterdam,undefined

[19] The Netherlands e-mail: BCHvanderWal@yahoo.com Tel.: +31-20-6464114,undefined

[20] Fax: +31-294-282578,undefined

来源：

Virchows Archiv | 2000年 / 436卷

关键词：

Key words Adults; Hyperinsulinemia; Hypoglycemia; Nesidioblastosis;

D O I：

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学科分类号：

摘要：

Nesidioblastosis is rare in adults and accounts for 0.5–5% of cases of organic hyperinsulinemia. The diagnosis of nesidioblastosis should be considered when peroperative imaging modalities fail to localize a lesion in patients with hyperinsulinism. Two female patients, aged 55 and 16 years, with hyperinsulinemic hypoglycemia are reported. Somatostatin receptor scintigraphy showed slight focal activity in both patients. The first patient underwent a Whipple procedure and became diabetic. The second patient underwent a distal hemi-pancreatectomy and suffered from recurrent hypoglycemic episodes 3 months after surgery, for which she is presently being treated with octreotide. Histological examination of the resected pancreata revealed focally increased islet tissue and a number of slightly hypertrophic beta cells. Such histological abnormalities have been related to functional changes of β-cells. In infantile nesidioblastosis, a proportion of cases has been associated with mutations in one of several genes. Whether such mutations, leading to hyperinsulinism, also play a role in adult nesidioblastosis is presently unknown.

引用

页码：481 / 486

页数：5