Nesidioblastosis With Noninsulinoma Pancreatogenous Hypoglycemia Syndrome in a Patient With Type 2 Diabetes Mellitus
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- Homma Reiko
- Division of Endocrinology and Metabolism, Asahikawa Kosei General Hospital
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- Iida Takahisa
- Division of Endocrinology and Metabolism, Asahikawa Kosei General Hospital
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- Miura Takanori
- Division of Endocrinology and Metabolism, Asahikawa Kosei General Hospital
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- Fujinaga Akihiro
- Division of Gastroenterology, Asahikawa Kosei General Hospital
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- Hiramatsu Kazuhide
- Department of Radiology, Asahikawa Kosei General Hospital
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- Kosizuka Yasuyuki
- Department of Surgery, Asahikawa Kosei General Hospital
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- Sato Keisuke
- Department of Pathology, Asahikawa Kosei General Hospital
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- Suzuki Shigeru
- Department of Pediatrics, Asahikawa Medical University
Bibliographic Information
- Other Title
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- 2型糖尿病の経過中に高インスリン血症性低血糖を繰り返した膵島細胞症の1例
Abstract
<p>We present the case of a 56-year-old man with type2 diabetes who experienced frequent episodes of hypoglycemia despite discontinuing antidiabetic medication while being admitted to our cardiology department for coronary artery stenting. The patient was diagnosed with hyperinsulinemic hypoglycemia based on the findings of various tests (fasting blood glucose 36 mg/dL, insulin level 64.3 μU/mL, CPR level 13.3 ng/mL), and further investigations were conducted. Abdominal ultrasonography, CT, and MRI did not reveal any pancreatic tumors. Owing to the difficulty of performing invasive tests immediately after coronary stent placement, the patient was treated with diazoxide. However, the hypoglycemic episodes persisted and increased with the increasing doses of diazoxide. A Selective Arterial Calcium Injection (SACI) test showed positive findings, thus leading to the patient's decision to undergo surgery. A pathological examination confirmed hyperplasia of the pancreatic islet cells corresponding to the positive SACI test site, thereby leading to a diagnosis of nesidioblastosis. While the occurrence of nesidioblastosis in a patient with type2 diabetes is rare, in cases where no evident pancreatic tumors are present, we should consider the possibility of nesidioblastosis and carefully select the optimal surgical and treatment approaches.</p>
Journal
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- Journal of the Japan Diabetes Society
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Journal of the Japan Diabetes Society 67 (4), 181-188, 2024-04-30
THE JAPAN DIABETES SOCIETY
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Keywords
Details 詳細情報について
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- CRID
- 1390862931516956160
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- ISSN
- 1881588X
- 0021437X
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- Text Lang
- ja
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- Data Source
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- JaLC
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- Abstract License Flag
- Disallowed