Korean J Med.
2010 Mar;78(3):375-380.
A case of adult nesidioblastosis mimicking an insulinoma and autoimmune hypoglycemia
- Affiliations
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- 1Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. drshchoi@snu.ac.kr
- 2Department of Pathology, Seoul National University Bungdang Hospital, Seongnam, Korea.
- 3Department of Internal Medicine, Seoul National University Bungdang Hospital, Seongnam, Korea.
Abstract
- Hyperinsulinemic hypoglycemia in the absence of exogenous insulin use is caused by disorders such as insulinoma, diffuse beta-cell hyperplasia/nesidioblastosis, and autoimmune hypoglycemia. Nesidioblastosis is a rare cause of hypoglycemia in adults, accounting for 0.5~7.0% of organic hyperinsulinemia cases. Although pancreatic resection is considered the best treatment modality for curing nesidioblastosis, there is no consensus regarding the indications for and extent of the surgery due to its high risk and complication rate. A 75-year-old woman presented with an altered mental state, a mass suspected of being an insulinoma, and insulin receptor antibodies. The patient underwent surgery because of recurrent life-threatening hypoglycemia. Postoperative pathology of her pancreas revealed nesidioblastosis.
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