A Rare Case of Pancreatic Insulinoma, Sleep Apnea, and Hypertension

Abstract

Introduction: Pancreatic insulinomas are rare, usually benign, small neuroendocrine tumors that occur more frequently in women, with an average age of 47 years. Insulinomas are characterized by chronic hyperinsulinemia leading to recurrent hypoglycaemia. There is evidence that hyperinsulinemia and insulin resistance may be initial events in the genesis of arterial hypertension. The presumed link between hyperinsulinemia and hypertension is more common in individuals of European descent than in those of African descent. On the other hand, sleep apnea is one of the common causes of secondary hypertension. Case presentation: In this study, we present a 61-year-old male of Roma ethnicity with pancreatic insulinoma, hyperinsulinemia, recurrent hypoglycaemia, arterial hypertension, and sleep apnea. The clinical features of insulinoma include hypoglycaemia with neuroglycopenic symptoms, including mental confusion and behavioural changes. In the case of this individual patient, due to the development of resistant hypertension accompanied by headaches and ringing in the ears, intensified antihypertensive drug therapy was implemented. However, despite these measures, blood pressure regulation remained highly challenging. Conclusion: Pancreatic insulinoma in a 61-year-old male of Roma ethnicity with neuroglycopenic symptoms and the development of paroxysmal hypertension is a rare occurrence, despite hypertension typically not being associated with insulinoma. Sleep apnea serves as an additional exacerbating factor for the onset of secondary hypertension, further complicating blood pressure regulation.