Postprandial hypoglycemia in islet beta cell hyperplasia with adenomatosis of the pancreas

J. M. Tibaldi, D. Lorber, S. Lomasky, Jacob J. Steinberg, R. Reisman, Harry Shamoon

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Organic hyperinsulinism causing hypoglycemia in adults is caused by insulinoma, islet hyperplasia, or a combination of adenomata and hyperplasia. We present a patient with long-standing symptoms of postprandial hypoglycemia occurring within 15 minutes of meals in the absence of fasting hypoglycemic symptoms. An intravenous glucagon stimulation test resulted in a rise of plasma insulin from 194 to 21,883 pmol/L at 7.5 minutes. Blood glucose simultaneously rose from 4.9 to 5.9 mmol/L. A glucose tolerance test revealed an exuberant insulin response. A euglycemic hyperinsulinemic clamp demonstrated incomplete suppression of plasma C-peptide. At surgery, three nodules were found and a 50-60% distal pancreatectomy was performed. The pancreas revealed a combination of multiple β-cell islet adenomata and islet hyperplasia with no evidence of nesidioblastosis. The coexistence of islet adenomata with hyperplasia must be considered in the differential diagnosis of postprandial hypoglycemia.

Original languageEnglish (US)
Pages (from-to)53-57
Number of pages5
JournalJournal of Surgical Oncology
Volume50
Issue number1
DOIs
StatePublished - 1992

Fingerprint

Islets of Langerhans
Hypoglycemia
Hyperplasia
Pancreas
Adenoma
Nesidioblastosis
Insulin
Islet Cell Adenoma
Insulinoma
Pancreatectomy
Glucose Clamp Technique
C-Peptide
Hyperinsulinism
Glucose Tolerance Test
Glucagon
Hypoglycemic Agents
Meals
Blood Glucose
Fasting
Differential Diagnosis

Keywords

  • differential diagnosis
  • glucagon stimulation test
  • hyperinsulinemia
  • hyperinsulinemic clamp
  • hypoglycemia
  • pancreatectomy
  • pancreatic adenomatosis

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Postprandial hypoglycemia in islet beta cell hyperplasia with adenomatosis of the pancreas. / Tibaldi, J. M.; Lorber, D.; Lomasky, S.; Steinberg, Jacob J.; Reisman, R.; Shamoon, Harry.

In: Journal of Surgical Oncology, Vol. 50, No. 1, 1992, p. 53-57.

Research output: Contribution to journalArticle

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