ID | 116831 |
タイトル別表記 | インスリノーマの症例報告
Insulinoma with symptoms of suspected transient ischemic attack : A case report
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著者 |
吉川, 紘平
徳島大学
金子, 遥祐
徳島大学
辻, 誠士郎
徳島大学
河田, 沙紀
徳島大学
川原, 綾香
徳島大学
森, 建介
徳島大学
遠藤, ふうり
徳島大学
明比, 祐子
徳島大学
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キーワード | Insulinoma
Hypoglycemia
Neuroglycopenia
Transient ischemic attack
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資料タイプ |
学術雑誌論文
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抄録 | We report the case of a67-year-old woman who had symptoms suggestive of a transient ischemic attack(TIA), such as lightheadedness and transient visual changes before meals for 4 months. She experienced altered consciousness before lunch and was taken to the emergency room2weeks ago. She had repeated hypoglycemia with a blood glucose level of 31 mg/dL. Insulin secretion was not suppressed, with an immunoreactive insulin level of 14.0 μU/mL and connecting peptide immunoreactivity of 1.83 ng/mL for occasional blood glucose levels of 49 mg/dL. Dynamic CT revealed a 17‐mm mass enhanced during the arterial phase in the pancreatic uncinate process, suggestive of a pancreatic neuroendocrine tumor. A selective arterial secretagogue(calcium)injection test revealed the localization of insulinoma in the head of the pancreas. Therefore, pancreatoduodenectomy was performed. Hyperglycemia occurred after the surgery, and it was judged that the insulinoma was resected. This case showed TIA-like symptoms without signs of sympathetic overdrive associated with hypoglycemia. Thus, the diagnosis was delayed. Insulinoma may present with symptoms of neuroglycopenia but not autonomic activity due to hypoglycemia. Insulinoma should be distinguished in patients with unknown neurological symptoms since neuroglycopenia caused by insulinoma is diverse.
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掲載誌名 |
四国医学雑誌
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ISSN | 00373699
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cat書誌ID | AN00102041
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出版者 | 徳島医学会
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巻 | 77
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号 | 5-6
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開始ページ | 275
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終了ページ | 280
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並び順 | 275
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発行日 | 2021-12-25
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EDB ID | |
フルテキストファイル | |
言語 |
jpn
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著者版フラグ |
出版社版
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部局 |
病院
医学系
先端酵素学研究所
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