title: Insulinoma associated with pregnancy.
abstract: OBJECTIVE
  To report three cases of insulinoma associated with pregnancy.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Divisions of Endocrinology and Gastroenterologic Surgery, Hospital de Clínicas, University of Buenos Aires, Argentina.
  
  
  METHODS
  Three patients with hypoglycemic signs due to insulinoma appearing during pregnancy or shortly after delivery.
  
  
  METHODS
  Laparoscopic excision of insulinoma in two and laparotomy in one of the patients were performed after the end of their pregnancies.
  
  
  METHODS
  Disappearance of hypoglycemic crises and histologic proof of insulinomas.
  
  
  RESULTS
  In two of the three patients, hypoglycemia occurred within 2-12 weeks after delivery, suggesting that signs could have been masked because of metabolic changes during gestation; in the third patient, hypoglycemia appeared in the first trimester but was misinterpreted.
  
  
  CONCLUSIONS
  Insulinoma is often not suspected during the first trimester of pregnancy because signs resemble episodes of hypotension or emesis. Later, with the increase in insulin resistance, symptoms subside.
authors.affiliation: Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Adriana G
authors.initials: AG
authors.lastname: Diaz
authors.forename: Javier
authors.initials: J
authors.lastname: Herrera
authors.forename: Mariana
authors.initials: M
authors.lastname: López
authors.forename: Félix M
authors.initials: FM
authors.lastname: Puchulu
authors.forename: Pedro
authors.initials: P
authors.lastname: Ferraina
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Bruno
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000601:surgery; D007340:Insulinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010535:Laparoscopy; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D049590:Postpartum Period; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000601:surgery; D011261:Pregnancy Trimester, First; D016896:Treatment Outcome