تقرير
Endogenous hyperinsulinism: diagnostic and therapeutic difficulties.
| العنوان: | Endogenous hyperinsulinism: diagnostic and therapeutic difficulties. |
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| المؤلفون: | Gouta EL; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Jerraya H; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Dougaz W; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Chaouech MA; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Bouasker I; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Nouira R; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia., Dziri C; Surgical Department B, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia. |
| المصدر: | The Pan African medical journal [Pan Afr Med J] 2019 May 27; Vol. 33, pp. 57. Date of Electronic Publication: 2019 May 27 (Print Publication: 2019). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: African Field Epidemiology Network Country of Publication: Uganda NLM ID: 101517926 Publication Model: eCollection Cited Medium: Internet ISSN: 1937-8688 (Electronic) NLM ISO Abbreviation: Pan Afr Med J Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kampala, Uganda : African Field Epidemiology Network |
| مواضيع طبية MeSH: | Hyperinsulinism/*diagnosis , Insulinoma/*diagnosis , Pancreatectomy/*methods, Adult ; Aged, 80 and over ; Blood Glucose/analysis ; Female ; Humans ; Hyperinsulinism/etiology ; Hyperinsulinism/surgery ; Insulinoma/complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreaticoduodenectomy/methods ; Retrospective Studies ; Splenectomy/methods ; Tomography, X-Ray Computed |
| مستخلص: | Endogenous hyperinsulinism is an abnormal clinical condition that involves excessive insulin secretion, related in 55% of cases to insulinoma. Other causes are possible such as islet cell hyperplasia, nesidioblastosis or antibodies to insulin or to the insulin receptor. Differentiation between these diseases may be difficult despite the use of several morphological examinations. We report six patients operated on for endogenous hyperinsulinism from 1 st January 2000 to 31 st December 2015. Endogenous hyperinsulinism was caused by insulinoma in three cases, endocrine cells hyperplasia in two cases and no pathological lesions were found in the last case. All patients typically presented with adrenergic and neuroglycopenic symptoms with a low blood glucose level concomitant with high insulin and C-peptide levels. Computed tomography showed insulinoma in one case out of two. MRI was carried out four times and succeeded to locate the lesion in the two cases of insulinoma. Endoscopic ultrasound showed one insulinoma and provided false positive findings three times out of four. Intra operative ultrasound succeeded to localize the insulinoma in two cases but was false positive in two cases. Procedures were one duodenopancreatectomy, two left splenopancreatectomy and two enucleations. For the sixth case, no lesion was radiologically objectified. Hence, a left blind pancreatectomy was practised but the pathological examination showed normal pancreatic tissue. Our work showed that even if morphological examinations are suggestive of insulinoma, other causes of endogenous hyperinsulinism must be considered and therefore invasive explorations should be carried out. Competing Interests: The authors declare no competing interests. |
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| فهرسة مساهمة: | Keywords: Insulinoma; endogenous hyperinsulinism; hypoglycemia |
| المشرفين على المادة: | 0 (Blood Glucose) |
| تواريخ الأحداث: | Date Created: 20190827 Date Completed: 20190926 Latest Revision: 20200225 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC6689824 |
| DOI: | 10.11604/pamj.2019.33.57.18885 |
| PMID: | 31448019 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1937-8688 |
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| DOI: | 10.11604/pamj.2019.33.57.18885 |