J Korean Soc Endocrinol.  1994 Sep;10(3):273-277.

A Case of Nesidioblastosis in Adult with Hyperinsulinemic Hypoglycemia

• Shong YK
• Kim HK
• Min YJ
• Park JY
• Hong SK
• Lee KU
• Han DJ
• Lee HJ
• Kim GS
• Gong GY

Abstract

Nesidioblastosis is a primarily childhood disease which is often associated with hyperinsulinemic hypoglycemia. It is very rarely found in adults. Only a few well documented cases are found in the world interature. The authors have recently experienced a case of nesidioblastosis in an adult. A 55-year-old man was admitted due to repeated episodes of reversible loss of consciousness. Hyperinsulinemic hypoglycemia was documented. Under the presumptive diagnosis of insulinoma, localization procedures were done but no definite tumor was found. Only suspicious gradient in insulin concentration was found around the head of pancreas by percutaneous transhepatic portal venous sampling. Exploratory laparotomy was performed and Whipple's operation was done. Seventy percent of proximal pancreas was removed. Histomorphometric study of the resected specimen revealed uneven graded hyperplasia of the islet cells with the most profuse hyperplasia in the head region and progressive decrease in the degree of hyperplasia to the body and tail. The patient remains euglycemia until 6 months after operation since immediate postoperative period and can tolerate 24 hour fasting without any medication.

MeSH Terms

Adult*
Diagnosis
Fasting
Head
Humans
Hyperplasia
Hypoglycemia*
Insulin
Insulinoma
Islets of Langerhans
Laparotomy
Middle Aged
Nesidioblastosis*
Pancreas
Postoperative Period
Tail
Unconsciousness
Insulin