1.A Case of Isolated ACTH Deficiency
Sang Jin KIM ; Kyung Mook CHOI ; Sei Hyun BAIK ; Dong Seop CHOI
Journal of Korean Society of Endocrinology 1995;10(4):445-450
solated ACTH deficiency is a very uncommon cause of hypoadrenocorticism, with less than 200 cases reported in the literatures. The clinical presentation can be similar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The diagnosis is established by demonstrating hypocortisolism with undetectable serum levels of ACTH, normal adrenal responsiveness to prolonged ACTH infusion, and an absent ACTH response to insulin-induced hypoglycemia. Other endocrine function is normal.We experienced a case of isolated ACTH deficiency in 34 years old female who was admitted due to fever and drowsy mentality.So we present this case with a review of literatures.
Addison Disease
;
Adrenocorticotropic Hormone
;
Diagnosis
;
Female
;
Fever
;
Humans
;
Hyperpigmentation
;
Hypoglycemia
2.Pancreatic somatostatinoma characterized by extreme hypoglycemia.
Xiao-pei CAO ; Yuan-yuan LIU ; Hai-peng XIAO ; Yan-bing LI ; Lian-tang WANG ; Ping XIAO
Chinese Medical Journal 2009;122(14):1709-1712
Blood Glucose
;
analysis
;
Humans
;
Hypoglycemia
;
diagnosis
;
etiology
;
pathology
;
Male
;
Somatostatinoma
;
complications
;
diagnosis
;
pathology
;
Young Adult
3.A Case of Insulinoma Mimicking Complex Partial Seizure.
Byung Woo YOON ; Kwang Woo LEE ; Jae Kyu ROH ; Sang Bok LEE ; Ho Jin MYUNG ; Seung Keun OH ; Eui Keun HAM
Journal of the Korean Neurological Association 1988;6(1):101-109
Insulinoma is a rare tumor occurring more often in the older age range. Because of the neuroglycopenic symptoms initial misdiagnosis or the delayed diagnosis are frequent. We recently experienced a case of insulinoma in a 50-year-old female with the symptoms of complex partial seizure, who had been treated with the antiepileptic drugs. Hypoglycemia was detected and the parenteral supplement of glucose rapidly reversed her symptoms, and the prolonged fasting test showed the pattern of insulinoma. Curative surgery was performed. So we report a case of insulinoma with the review of literature.
Anticonvulsants
;
Delayed Diagnosis
;
Diagnostic Errors
;
Fasting
;
Female
;
Glucose
;
Humans
;
Hypoglycemia
;
Insulinoma*
;
Middle Aged
;
Seizures*
4.A Case of Surgically Treated Insulinoma in Pregnancy.
Kwan Woo LEE ; Euy Young SOH ; Young Goo SHIN ; Sung Keun LEE ; So Yun PARK ; Sung Kyu LEE ; Yun Suk CHUNG ; Hyun Man KIM ; Kyung Joo HWANG ; Yun Mi JIN
Journal of Korean Society of Endocrinology 1998;13(2):288-294
Insuliin secreting tumor is 70% prevalent disease in female and predoadnant in forth and sixth deeade. The incidence of insulinoma is one case per 250,000 patient-years. Insulinoma in pregnancy was extremely rare, and the prevalence was not reported. The diagnosis of an insulinoma is depend on demonstration of hypoglycemia with high insulin and C-peptide levels. Immunoreactive insulin/plasma glucose ratio0.3 in particular support the diagnosis of an insulinoma. Fetal complication would be developed because of hypoglycemia. In approximately half of the cases reported, surgical exploration was done during pregrancy, the remainder were treated after delivery. Insulinoma poses serious diagnostic and therapeutic problems when she is pregnant. We experienced a case of insulinoma in pregnancy that represented Whipples triad and was treated by surgical intervention.
C-Peptide
;
Diagnosis
;
Female
;
Glucose
;
Humans
;
Hypoglycemia
;
Incidence
;
Insulin
;
Insulinoma*
;
Pregnancy*
;
Prevalence
5.Difficult diagnosis and localization of focal nesidioblastosis: clinical implications of ⁶⁸Gallium-DOTA-D-Phe¹-Tyr³-octreotide PET scanning.
Jae Ri KIM ; Jin Young JANG ; Yong Chan SHIN ; Young Min CHO ; Hongbeom KIM ; Wooil KWON ; Young Min HAN ; Sun Whe KIM
Annals of Surgical Treatment and Research 2016;91(1):51-55
Focal nesidioblastosis is a rare cause of endogenous hyperinsulinemic hypoglycemia in adults. Because it is difficult to localize and detect with current imaging modalities, nesidioblastosis is challenging for biliary-pancreatic surgeons. ⁶⁸Gallium-DOTA-D-Phe¹-Tyr³-octreotide PET scanning and ¹¹¹indium-pentetreotide diethylene triamine pentaacetic acid octreotide scanning may be superior to conventional imaging modalities in determining the localization of nesidioblastosis. We report the successful surgical treatment of a 54-year-old woman with focal hyperplasia of the islets of Langerhans, who experienced frequent hypoglycemic symptoms and underwent various diagnostic examinations with different results.
Adult
;
Diagnosis*
;
Female
;
Humans
;
Hyperplasia
;
Hypoglycemia
;
Islets of Langerhans
;
Middle Aged
;
Nesidioblastosis*
;
Octreotide
;
Positron-Emission Tomography*
;
Surgeons
6.Difficult diagnosis and localization of focal nesidioblastosis: clinical implications of ⁶⁸Gallium-DOTA-D-Phe¹-Tyr³-octreotide PET scanning.
Jae Ri KIM ; Jin Young JANG ; Yong Chan SHIN ; Young Min CHO ; Hongbeom KIM ; Wooil KWON ; Young Min HAN ; Sun Whe KIM
Annals of Surgical Treatment and Research 2016;91(1):51-55
Focal nesidioblastosis is a rare cause of endogenous hyperinsulinemic hypoglycemia in adults. Because it is difficult to localize and detect with current imaging modalities, nesidioblastosis is challenging for biliary-pancreatic surgeons. ⁶⁸Gallium-DOTA-D-Phe¹-Tyr³-octreotide PET scanning and ¹¹¹indium-pentetreotide diethylene triamine pentaacetic acid octreotide scanning may be superior to conventional imaging modalities in determining the localization of nesidioblastosis. We report the successful surgical treatment of a 54-year-old woman with focal hyperplasia of the islets of Langerhans, who experienced frequent hypoglycemic symptoms and underwent various diagnostic examinations with different results.
Adult
;
Diagnosis*
;
Female
;
Humans
;
Hyperplasia
;
Hypoglycemia
;
Islets of Langerhans
;
Middle Aged
;
Nesidioblastosis*
;
Octreotide
;
Positron-Emission Tomography*
;
Surgeons
7.Pancreatic islet-cell adenoma.
Ji Hong KIM ; Ho Seong KIM ; Duk Hi KIM ; Hyun Yee IM ; Chan Il PARK
Journal of the Korean Pediatric Society 1993;36(6):870-876
Pancreatic islet cell adenoma is a benign tumor of pancreatic beta-cell and a rare cause of hyperinsulinemic hypoglycemia in children. The authors experienced a case of pancreatic islet cell adenoma(Insulinoma)in a 11 year and 8 month old male who had frequent loss of consciousness and seizure. Enucleation was done after localization of tumor by selective celiac artery angiography and abdominal computed tomography. Diagnosis was confirmed by histologic findings as pancreatic-adenoma, gyriform growth pattern. A brief review of related literature was made.
Adenoma*
;
Angiography
;
Celiac Artery
;
Child
;
Diagnosis
;
Humans
;
Hyperinsulinism
;
Hypoglycemia
;
Infant
;
Islets of Langerhans
;
Male
;
Seizures
;
Unconsciousness
8.Nesidioblastosis in an Elderly Patient with Hyperinsulinemic Hypoglycemia.
Ye Kyung SEO ; Jik Hwa NAM ; Byung Ho SIN ; Jung Guk KIM ; Sung Woo HA ; Bo Whn KIM ; Sang Won JUNG ; Young Guk YUN ; In Su SEO ; Chang Ho CHO
Journal of Korean Society of Endocrinology 1997;12(3):485-492
Nesidioblastosis is characterized by a diffuse proliferation of islet cells arising from pancreatic ducts and is the most common cause of hyperinsulinemic hypoglycemia in newborns and infantile. It is exceedingly rare in adults and no concensus regarding its diagnosis and management is available. We herein describe an elderly man with fasting hypoglycemia, inappropriate insulin hypersecretion. And pathologic examination of his pancreas revealed the characteristic finding of nesidioblastosis confirmed by immunohistochemical stain.
Adult
;
Aged*
;
Diagnosis
;
Humans
;
Hypoglycemia*
;
Infant, Newborn
;
Insulin
;
Islets of Langerhans
;
Nesidioblastosis*
;
Pancreas
;
Pancreatic Ducts
9.Anesthesia for an Insulinoma Case .
Kyung Shin MIN ; Ou Kyoung KWON
Korean Journal of Anesthesiology 1983;16(4):470-473
The insulinoma is a rare tumor, usually small, solitary and benign with no prediction for any part of the pancreas. It is amendable to surgical cure but approximately 10percent are malignant and the peak incidence is encountered between ages 40~60. Surgery has been established as the treatment of choice. The reason for electing to operate rather than treat symptomatically is prevention of complications, such as increasing obesity, or prolonged and irreversible episodes of hypoglycemic coma with resultant permanent central nervous damage. During the anesthesia for a patient with insulinoam, the important problems are to recognize and treat hypoglycemia. This is a case report of a patient with insulinoma who underwent surgical treatment. Two years age, under the diagnosis of insulinoma, she was underwent distal pancreatectomy with splenectomy. But 3 months ago, hypoglycemic attacks recurred during fasting periods surgical intervention was performed under the diagnosis of recurrent insulinoma. She was anesthetized with thalamonal-nitrous oxide-oxygen, pancuronium, and 10 percent dextrose solution was administered throughout the operation. We monitered the level of blood sugar intermittently by using a rapie sugar analyser(Glucometer, Ames, Japan). No hypoglycemic episode during anesthesia was observed. We report the case of our anesthetic experience withan insulinoma and review the anesthetic choice and the management of the patient.
Anesthesia*
;
Blood Glucose
;
Coma
;
Diagnosis
;
Fasting
;
Glucose
;
Humans
;
Hypoglycemia
;
Incidence
;
Insulinoma*
;
Obesity
;
Pancreas
;
Pancreatectomy
;
Pancuronium
;
Splenectomy
10.A Case of Insulinoma Presenting as Repetitive Abnormal Behavior with Amnesia.
Sang Wuk SOHN ; Byeol A YOON ; Hyung Jin LEE ; Dong Hyun SHIM ; Kyung Won PARK
Dementia and Neurocognitive Disorders 2014;13(4):146-149
Insulinomas are very rare tumors. Diagnosis of insulinoma is often delayed or misdiagnosed because of its various symptoms. We report a patient with hypoglycemic encephalopathy who had repetitive behavior changes, diagnosed as a pancreatic insulinoma. A 52 years old man was referred to a memory and dementia clinic for evaluation of his repetitive abnormal behavior changes. He has threatened his wife with violent acts and showed aggressive behaviors, but he couldn't remember when he was recovered to normal state. During the hospitalization, we noticed that his repetitive abnormal behaviors were correlated to severe hypoglycemia. After we corrected glucose level, his symptoms were disappeared. We performed an abdomen-pelvis CT scan, revealing pancreatic head tumor. After he took surgical treatment, His symptoms were fully recovered. Our case demonstrates that various neurological symptoms, such as abnormal behavior, rarely occur due to recurrent hypoglycemia in patient with insulinoma.
Amnesia*
;
Dementia
;
Diagnosis
;
Glucose
;
Head
;
Hospitalization
;
Humans
;
Hypoglycemia
;
Insulinoma*
;
Memory
;
Spouses
;
Tomography, X-Ray Computed