Insulinoma in chronic renal failure: a case report.
The diagnosis of insulinoma depends on the fulfillment of well-established criteria during the 72-h fast. However, these criteria rely on normal renal function. Spontaneous hypoglycemia that is not attributable to insulinoma may occur in persons with renal failure. We describe herein a patient with renal impairment who had undergone renal transplant and had a 20-yr history of hypoglycemic symptoms and successful resection of insulinoma. Although the results of a 72-h fast were consistent with endogenous hyperinsulinemia, their interpretation was complicated in the presence of renal impairment. Fortunately, the identification of the tumor, by endoscopic ultrasonograph, led to a correct diagnosis. This case seems to be the second report of a patient with insulinoma with concomitant renal failure.
Basu
Ananda
A
Marshfield Clinic, Wausau, Wisconsin 54401, USA. basu.ananda@mayo.edu
Sheehan
Michael T
MT
Thompson
Geoffrey B
GB
Service
F J
FJ
D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D007003:Hypoglycemia / Q000209:etiology; D007340:Insulinoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography