Noninsulinoma pancreatogenous hypoglycemic syndrome - A case report and review of literature

Ting I. Lee, Hong Jyi Yang, Fan Fen Wang, Ging Shing Won, Mei Tze Lee, Hong Da Lin, Kam Tsun Tang

Research output: Contribution to journalArticle

Abstract

Nesidioblastosis is a diffuse proliferative process of pancreatic islet cells characterized by hyperinsulinemic hypoglycemia. This is a rare cause of hypoglycemia in adults and is presently designated as noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS). Here, we report a case. A 75 years old male patient found unconscious was send to our emergency room where inappropriate elevation of C-peptide and insulin level were found during hypoglycemia and his conscious recovered after glucose infusion. He has no history of diabetes and denied taking any medicine. He suffered from cold sweating and weakness recently. Seventy two-hour prolonged fasting was inconclusive, but C-peptide suppression test showed non-suppression of C-peptide 60 min after insulin infusion. Glucagon test showed an enhanced increment in insulin and C-peptide level 5 min after glucagon injection. CT scan of abdomen showed no tumor growth in the pancreas or other organs. Selective arteriography with calcium infusion test showed 2-3 fold increased in insulin level after calcium infusion at the splenic, superior mesenteric and gastroduodenal arteries. Explore laparotomy revealed no tumor in the pancreas and distal pancreactectomy was performed. Diagnosis of NIPHS was confirmed by pathological examination. No hypoglycemic episode was noted during this 2.5 years follow-up. Unfortunately, he died of COPD unrelated to hypoglycemia or NIPHS at other hospital in 2001.

Original languageEnglish
Pages (from-to)133-140
Number of pages8
JournalJournal of Internal Medicine of Taiwan
Volume13
Issue number3
Publication statusPublished - 2002

    Fingerprint

Keywords

  • Hypoglycemia
  • Noninsulinoma pancreatogenous hypoglycemic syndrome;NIPHS
  • Selective arterial calcium infusion test

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Lee, T. I., Yang, H. J., Wang, F. F., Won, G. S., Lee, M. T., Lin, H. D., & Tang, K. T. (2002). Noninsulinoma pancreatogenous hypoglycemic syndrome - A case report and review of literature. Journal of Internal Medicine of Taiwan, 13(3), 133-140.