直近一年間の累計
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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
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
キーワード
Insulinoma
Hypoglycemia
Neuroglycopenia
Transient ischemic attack
資料タイプ
学術雑誌論文
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
77
5-6
開始ページ
275
終了ページ
280
並び順
275
発行日
2021-12-25
EDB ID
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系
先端酵素学研究所