Hypoglycémie et insulinome

Cazabat, Laure; Chanson, P.

doi:10.1016/s0003-4266(09)72470-9

Cited by 8 publications

(6 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In case of single tumor, with benign character, like our patient, the possibility of recovery is between 75 to 98 % and survival percentage without relapse is more than 90 % after 5 years (6). The association with diabetes mellitus does not alter the prognosis.…”

Section: Discussionsupporting

confidence: 49%

Association of Insulinoma and Type 2 Diabetes Mellitus

Ouleghzal

Ziadi

Menfaa

et al. 2016

Int J Endocrinol Metab

View full text Add to dashboard Cite

The association of diabetes mellitus and insulinoma is unusual. We are reporting the case of a 58 years old patient having diabetes mellitus type 2 for several years. This patient was well balanced with oral anti-diabetic treatment. However, the diagnosis of insulinoma was discussed due to recent episodes of hypoglycemia that persisted even after stopping the treatment. Abdominal CT allowed the topographic diagnosis. The patient underwent a caudal pancreatectomy. Furthermore, the postoperative period shows that the diabetes mellitus requires the oral anti-diabetic treatment and basal insulin have to be stable. Then, the occurrence of hypoglycemia in the diabetic mellitus type 2 and, especially the persistence after discontinuation of therapy, suggest the unusual diagnosis of insulinoma as illustrated in our observation.

show abstract

Section: Discussionsupporting

confidence: 49%

Association of Insulinoma and Type 2 Diabetes Mellitus

Ouleghzal

Ziadi

Menfaa

et al. 2016

Int J Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…The incidence of insulinoma is approximately 3-10 cases per million persons per year in the United States [4,6] and proinsulin-only secreting islet cell tumors causing hypoglycemia are even rarer [5][6][7][8] . The diagnosis of an insulinoma or proinsulinomas is confirmed biochemically with a simultaneous low blood sugar and inappropriately elevated serum insulin, pro-insulin and/or c-peptide levels [4,9,10] . Localization of the tumor is usually established by imaging or angiography, and the definitive treatment is surgical resection of the tumor followed by resolution of the hypoglycemia [11] .…”

Section: Introductionmentioning

confidence: 99%

Proinsulinoma causing severe hypoglycemia in a patient with type 1 diabetes mellitus

Bertheau¹,

Herceg

Malgor

et al. 2014

CRCP

View full text Add to dashboard Cite

Case presentation: A 49 year male a 35 year history of Type 1 Diabetes Mellitus (T1DM) was evaluated for recurrent episodes of hypoglycemia. After being weaned off of all exogenous insulin, the patient continued to have frequent and severe episodes of hypoglycemia often associated with seizures. Results:During an observed hypoglycemic reaction in our office he was found to have a serum glucose level of 64 mg/dl, a serum insulin level of 64 μIU/ml (reference range is <17 μIU/ml) and a C-peptide level of 0.6 ng/ml (reference range is 0.8 ng/ml -3.1 ng/ml). Serum and urine sulfonylurea levels were negative. During a formal diagnostic 72 hour fast, he developed severe hypoglycemia within four hours of beginning the fast and seized. No diagnostic laboratory studies were obtained during the hypoglycemic event! He underwent surgical exploration, where a 0.8 cm well-differentiated, islet cell tumor was resected. Following resection of the tumor, the spontaneous hypoglycemia resolved, and maintenance exogenous insulin was reinstituted. Histoimmunochemical staining was positive for chromogranin, synaptophysin, amylin, and proinsulin but negative for insulin. Immunostaining of the tumor was also positive for Toll-like receptors-3 (TLR3) and Wnt5a.Conclusion: This is the first case report of a patient with a long history of T1DM who developed a recurrent hypoglycemia due to a proinsulin-secreting islet cell tumor which resolved following its resection.

show abstract

“…It should be noticed that medical treatment can be suggested if insulinoma is not localized, if the patient refuses surgery or if their general condition does not allow it or even in case of inextirpable metastatic disease. It controls hypoglycemia symptoms in 50% to 60% of the cases [8]. The drugs used in efficiency order are diazoxide at 300 to 600 mg/day, octreotide and corticoids in case of failure of the former two.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycemia Controlled by Prednisone in an Occult Insulinoma or a Nesidioblastosis

Kerekou¹,

Aziz²,

Dedjan³

et al. 2019

OJEMD

View full text Add to dashboard Cite

Insulinoma is a pancreatic endocrine tumor lower in size than 20 mm in 80% of the cases and his treatment is chirurgical. However, in certain circumstances such as an occult location or circumstances of metastases, medical treatment is called for. Observation: A 29 years old patient with no specific pathological antecedents has presented severe hypoglycemia mainly in the morning. A patient was in a generally good condition. The fasting test revealed an inappropriate secretion of insulin at a venous glycemia of 0.35 g/l; which was corroborated by Turner index and altered glucose insulin index that we calculated. Moreover, the 8 h cortisolemia was normal at 90.13 ng/l, the TSH was normal at 1.44 µui/l, anti-insulin antibodies were negative at 6.7 U/l; the search of hypoglycemic sulfonamides was negative. Morphologically, she had three pancreatic tomodensitometry these were normal. She also had echo-endoscopy which showed a normal pancreas. The surgical exploration with preoperative echo is advised only after surgeon's assessment when the technical conditions are not put together. The diagnosis of the occult insulinoma or of nesidioblastosis was retained. The medical treatment was retained. Due to the unavailability of diazoxide in our pharmacies and the high cost of analogs of somatostatine, she was provided with prednisone 0.5 mg/kg/24h which was 40 mg/day after common agreement. The evolution was favorable. Conclusion: It should be noticed that medical treatment can be suggested if insulinoma is not localized. This observation proves that the localization of the insulinoma can be unsuccessful. It should also be noticed that our experience is the fourth described in literature, where hypoglycemia in insulinomas is controlled by prednisone.

show abstract

Hypoglycémie et insulinome

Cited by 8 publications

References 70 publications

Association of Insulinoma and Type 2 Diabetes Mellitus

Association of Insulinoma and Type 2 Diabetes Mellitus

Proinsulinoma causing severe hypoglycemia in a patient with type 1 diabetes mellitus

Hypoglycemia Controlled by Prednisone in an Occult Insulinoma or a Nesidioblastosis

Contact Info

Product

Resources

About