title: Histological insights into the pathogenesis of post-Roux-en-Y hyperinsulinaemic hypoglycaemia.
abstract: BACKGROUND
  β-cell hyperplasia has been implicated in the aetiology of post Roux-en-Y gastric bypass hyperinsulinaemic hypoglycaemia, but the pathogenesis of this condition is still unclear.
  
  
  METHODS
  We report a case of a 52-year-old man with post-Roux-en-Y gastric bypass hyperinsulinaemic hypoglycaemia who underwent distal pancreatectomy to alleviate his symptoms. Pancreatic histopathology showed chronic pancreatitis with a corresponding loss of exocrine tissue and islet retention. Amyloid deposition was found in pancreatic islets. These features are more typically associated with Type 2 diabetes.
  
  
  CONCLUSIONS
  This case highlights the potential multifactorial pathogenesis of symptomatic hypoglycaemia after Roux-en-Y gastric bypass.
authors.affiliation: Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical Center, Ann Arbor, MI, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Lash
authors.forename: T J
authors.initials: TJ
authors.lastname: Giordano
authors.forename: A G
authors.initials: AG
authors.lastname: Moraitis
authors.forename: I
authors.initials: I
authors.lastname: Hodish
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000473:pathology; D015390:Gastric Bypass; D006801:Humans; D006946:Hyperinsulinism / Q000473:pathology* / Q000601:surgery; D006965:Hyperplasia; D007003:Hypoglycemia / Q000473:pathology* / Q000601:surgery; D050417:Insulin-Secreting Cells / Q000473:pathology*; D007515:Islets of Langerhans / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000473:pathology; D058225:Plaque, Amyloid / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology*