Adenoma of the Islets of Langerhans and Pregnancy

Insulinoma in Pregnancy

“…In these patients multilocularity of insulinoma is more frequent ( Service et al, 1991 ). In pregnancy, insulinomas are very rare, as refl ected by the limited number of case reports found in literature ( Campbell et al, 1939 ;Pompen et al, 1946 ;Serrano-Rios et al, 1976 ;Rubens et al, 1977 ;Wilson and Hugh, 1983 ;Osei et al, 1984 ;Shaw et al, 1985 ;Galun et al, 1986 ;Friedman et al, 1988 ;Hale and Hale, 1988 ;Garner and Tsang, 1989 ;Smythe et al, 1990 ;Liberman et al, 1991 ;Akanji et al, 1992 ;Atala and Tapia, 1992 ;Auinger et al, 1994 ; Bardet et al, 1994 ;Lowy and Chisholm, 2001 ;Takacs et al, 2002 ;Fredericks et al, 2002 ;M ü ssig et al, 2006 ;Diaz et al, 2008 ;Christiansen and Vestergaard, 2008 ;M ü ssig et al, 2008 ). Clinical signs and symptoms of insulinoma appear to be attenuated and, in some cases, even masked by pregnancy.…”

A case of insulinoma diagnosed postpartum with hypoglycemic symptoms that were masked during pregnancy

“…Intriguingly, symptoms reappeared immediately after delivery. This was thought to be due to increased insulin resistance during pregnancy, which elevated the blood glucose level and masked the hypoglycemic symptoms associated with insulinoma, as in previous cases 2,14,15,17‐20,22 …”

“…Insulinoma is a rare pancreatic NET that is the most common cause of endogenous hyperinsulinemic hypoglycemia in adults 1 . Although its occurrence in women during pregnancy or after delivery is considered exceptional, in the English literature, 25 cases of insulinoma during the perinatal period have been reported to date 2‐23 (Tables 4 and 5). To the best of our knowledge, this is the first report of a Japanese case of insulinoma with hypoglycemic symptoms in the postpartum period and diagnosed with insulinoma.…”

“…This was thought to be due to increased insulin resistance during pregnancy, which elevated the blood glucose level and masked the hypoglycemic symptoms associated with insulinoma, as in previous cases. 2,14,15,[17][18][19][20]22 Insulinoma is generally difficult to diagnose, even during early pregnancy, when there is no apparent increase in insulin resistance; there are several possible reasons for this. First, blood glucose levels in women during the first trimester tend to be low, because elevated estrogen levels increase both insulin secretion and insulin sensitivity.…”

“…1 In general, its occurrence in women during pregnancy or after delivery is considered exceptional. However, previous reports in the English literature have shown that insulinoma can occur during pregnancy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] or the postpartum period, 2,14,[17][18][19][20][21][22][23] especially immediately after delivery. 2,18,19,23 In these cases, hypoglycemic symptoms were masked during pregnancy and manifested in the postpartum period.…”