2006
DOI: 10.1111/j.1365-2265.2006.02629.x
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Clinical features and morphological characterization of 10 patients with noninsulinoma pancreatogenous hypoglycaemia syndrome (NIPHS)

Abstract: Our results strengthen the existence of this unique clinical hypoglycaemic syndrome from beta-cell hyperfunction as well as the value of the selective arterial calcium stimulation test in its correct diagnosis and localization. The mechanisms underlying beta-cell hyperfunction and release of insulin to calcium, however, remain poorly characterized. Nevertheless, in a subset of patients with NIPHS, there exists some, as yet undefined, pancreatic humoral/paracrine factor(s) other than proinsulin, amylin, PDX-1, … Show more

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Cited by 204 publications
(48 citation statements)
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“…Patients with chronic pancreatitis lose the ability to elevate their blood glucose level in the insulin-loading test [16,29]. Such patients frequently develop pancreatogenous diabetes mellitus because of acquired insulin secretion defi ciency.…”
Section: Discussionmentioning
confidence: 99%
“…Patients with chronic pancreatitis lose the ability to elevate their blood glucose level in the insulin-loading test [16,29]. Such patients frequently develop pancreatogenous diabetes mellitus because of acquired insulin secretion defi ciency.…”
Section: Discussionmentioning
confidence: 99%
“…Reluctance to routinely combine a glucose load or a test meal with the fasting test may be due to the notion that postprandial hypoglycemia may not be a real disease per se except for reactive adaptations as found in insulin-resistant obesity, early type-2 diabetes, or after gastric surgery [24]. Since description of the first patients with NIPHS [6][7][8] and the characteristic postprandial neuroglycopenia, the diagnostic workup of patients with a suspected hypoglycemic disorder has changed. We recently reported [8] that these patients also may demonstrate late fasting hypoglycemia, typically associated with detectable insulin levels that are inappropriately elevated in the presence of true biochemical hypoglycemia.…”
Section: Discussionmentioning
confidence: 99%
“…Only a subgroup of patients with insulinoma demonstrates grossly elevated insulin levels as well as insulin secretion totally uncoupled to the ambient blood glucose concentration [4,5]. Furthermore, patients with non-insulinoma pancreatogenic hypoglycemia syndrome (NIPHS) present predominantly postprandial neuroglycopenia rather than fasting hypoglycemia associated with low insulin levels [6][7][8]. Diagnostic limits for insulin, C-peptide, proinsulin, and insulin surrogate parameters [9] according to the plasma glucose concentration have been thoroughly defined for the standard 72-h supervised fasting test.…”
Section: Introductionmentioning
confidence: 99%
“…Slike symptomer skyldes gjerne postprandial hypoglykemi. Alvorlige symptomer som svimmelhet, synsforstyrrelser, kognitiv affeksjon, svekket bevissthet, besvimelse og kramper er beskrevet etter både gastrektomi og fedmekirurgi (8,9). Det skjer vanligvis ved plasmaglukoseverdier < 3,0 mmol/l (10).…”
Section: Symptombildeunclassified