Reversible brain cell damage due to hypoglycemia in a patient with insulinoma.
A case of an insulinoma with hypoglycemic attacks accompanied by episodes of unconsciousness in a 57-year-old woman is described. During the hypoglycemic spells the level of adenylate kinase (AK) in the cerebrospinal fluid (CSF) was elevated 6-fold above the normalized level obtained later from the patient being in a normoglycemic condition. CSF-AK was previously found to be a sensitive marker of subtle brain cell damage due to hypoxia. The increased efflux of AK into CSF during the insulinoma-induced hypoglycemia was most probably the result of a brain cell injury caused by shortage of glycolytic fuel.
Ronquist
G
G
Department of Clinical Chemistry, University Hospital, Uppsala, Sweden.
Frithz
G
G
D007516:Adenoma, Islet Cell / Q000150:complications*; D000263:Adenylate Kinase / Q000134:cerebrospinal fluid; D001921:Brain / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000201:enzymology / Q000209:etiology*; D007340:Insulinoma / Q000150:complications*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications*
D000263:Adenylate Kinase