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ID 116831
Title Alternative
インスリノーマの症例報告
Insulinoma with symptoms of suspected transient ischemic attack : A case report
Author
Yoshikawa, Kouhei Tokushima University
Kaneko, Yousuke Tokushima University
Tsuji, Seijirou Tokushima University
Kawata, Saki Tokushima University
Kawahara, Ayaka Tokushima University
Mori, Kensuke Tokushima University
Endo, Fuuri Tokushima University
Akehi, Yuko Tokushima University
Keywords
Insulinoma
Hypoglycemia
Neuroglycopenia
Transient ischemic attack
Content Type
Journal Article
Description
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.
Journal Title
Shikoku Acta Medica
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
77
Issue
5-6
Start Page
275
End Page
280
Sort Key
275
Published Date
2021-12-25
EDB ID
FullText File
language
jpn
TextVersion
Publisher
departments
University Hospital
Medical Sciences
Institute of Advanced Medical Sciences