Noninsulinoma pancreatogenous hypoglycemia syndrome: an update in 10 surgically treated patients.
Surgery
; 128(6): 937-44;discussion 944-5, 2000 Dec.
Article
em En
| MEDLINE
| ID: mdl-11114627
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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Base de dados:
MEDLINE
Assunto principal:
Pancreatectomia
/
Hipoglicemia
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article