Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery.

Authors

Service GJ, Thompson GB, Service FJ, et al. 

Institution

Department of Surgery, Mayo Clinic and Foundation, Rochester, MN, USA.

Source

N Engl J Med 2005 Jul 21; 353(3) :249-54.

Abstract

We describe six patients (five women and one man; median age, 47 years; range, 39 to 54) with postprandial symptoms of neuroglycopenia owing to endogenous hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass surgery. Except for equivocal evidence in one patient, there was no radiologic evidence of insulinoma. Selective arterial calcium-stimulation tests, positive in each patient, were used to guide partial pancreatectomy. Nesidioblastosis was identified in resected specimens from each patient, and multiple insulinomas were identified in one. Hypoglycemic symptoms diminished postoperatively. We speculate that hyperfunction of pancreatic islets did not lead to obesity but that beta-cell trophic factors may have increased as a result of gastric bypass.

Mesh

Adult
Female
Follow-Up Studies
Gastric Bypass
Humans
Hyperinsulinism
Hyperplasia
Hypoglycemia
Insulinoma
Islets of Langerhans
Male
Middle Aged
Nesidioblastosis
Obesity
Obesity, Morbid
Pancreatic Ducts
Pancreatic Neoplasms
Postoperative Complications
Postprandial Period

Language

eng

Pub Type(s)

Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

PubMed ID

16034010