Islet cell hyperplasia: an unusual cause of hypoglycemia in an adult.
This is a case presentation of a 32-year-old man with a one year history of symptomatic hypoglycemia and documented elevations of his fasting plasma insulin to glucose ratio, caused by islet cell hyperplasia. Islet cell hyperplasia is a common cause of hypoglycemia in the pediatric population, but is very rare in adults. As in the pediatric group, adults should be treated with subtotal (75-85%) resection of the pancreas and with diazoxide for symptomatic recurrence of hypoglycemia. We suggest that the term islet cell hyperplasia is preferred to designate a diffuse proliferation of endocrine cells that may express itself with different morphologic patterns, varying from case to case. Islet cell hyperplasia, therefore, comprises nesidioblastosis, endocrine cell budding from ductal structures, as well as islet and islet cell hypertrophy, septal islets, islet dysplasia, and adenomatosis. Immunohistochemistry is a valuable method for the demonstration of the polymorphic hormonal content of the proliferated islet cells. We propose that the term nesidioblastosis, previously used to describe some similar cases, should be avoided because of confusion about its definition.
Weinstock
G
G
Margulies
P
P
Kahn
E
E
Susin
M
M
Abrams
G
G
D000328:Adult; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007124:Immunoenzyme Techniques; D007328:Insulin / Q000032:analysis; D008297:Male; D010179:Pancreas / Q000473:pathology; D010182:Pancreatic Diseases / Q000150:complications* / Q000473:pathology; D013004:Somatostatin / Q000032:analysis
D007328:Insulin; D013004:Somatostatin