Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2006; 12(44): 7221-7224
Published online Nov 28, 2006. doi: 10.3748/wjg.v12.i44.7221
Hyperinsulinemic hypoglycemia due to adult nesidioblastosis in insulin-dependent diabetes
A Raffel, M Anlauf, SB Hosch, M Krausch, T Henopp, J Bauersfeld, R Klofat, D Bach, CF Eisenberger, G Klöppel, WT Knoefel
A Raffel, SB Hosch, M Krausch, CF Eisenberger, WT Knoefel, Department of General and Visceral Surgery, Heinrich-Heine University, Düsseldorf, Germany
M Anlauf, T Henopp, J Bauersfeld, G Klöppel, Department of Pathology, Christian-Albrechts University, Kiel, Germany
R Klofat, D Bach, Medizinische Klinik III, Klinikum Krefeld, Germany
Correspondence to: Martin Anlauf, MD, Institute of Pathology, University of Kiel, Michaelisstr. 11, Kiel 24105, Germany. manlauf@path.uni-kiel.de
Telephone: +49-431-5971138 Fax: +49-431-5973462
Received: June 11, 2006
Revised: June 28, 2006
Accepted: August 11, 2006
Published online: November 28, 2006
Abstract

In neonates, persistent hyperinsulinemic hypoglycemia (PHH) is associated with nesidioblastosis. In adults, PHH is usually caused by solitary benign insulinomas. We report on an adult patient who suffered from insulin-dependent diabetes mellitus, and subsequently developed PHH caused by diffuse nesidioblastosis. Mutations of the MEN1 and Mody 2/3 genes were ruled out. Preoperative diagnostic procedures, the histopathological criteria and the surgical treatment options of adult nesidioblastosis are discussed. So far only one similar case of adult nesidioblastosis subsequent to diabetes mellitus II has been reported in the literature. In case of conversion of diabetes into hyperinsulinemic hypoglycemia syndrome, nesidioblastosis in addition to insulinoma should be considered.

Keywords: Hyperinsulinemic hypoglycaemia; Adult nesidioblastosis; Diabetes; Multiple Endocrine Neoplasia Type 1; Insulinoma