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CASE REPORT
Year : 2012  |  Volume : 2  |  Issue : 2  |  Page : 45-47

Hypoglycemia due to an adult-onset nesidioblastosis, a diagnostic and management dilemma


1 Internal Medicine Department, Cleveland Clinic Foundation, Cleveland, USA
2 Internal Medicine Department, University of Kansas Medical Center, Kansas City, USA

Correspondence Address:
Mohammad Taha
Kansas University Medical Center, Division of General & Geriatric Medicine, Mailstop 1020, 3901 Rainbow Boulevard, 6040 Delp, Kansas City, KS 66160
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-0770.99164

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We describe a case of a 40 year old patient with recurrent severe fasting and postprandial symptomatic hypoglycemia that occurred 6 years after gastric bypass surgery. The hypoglycemia was associated with increased insulin and C peptide but all diagnostic modalities for localizing an insulinoma were negative. Medical management failed to control symptoms and the patient underwent subtotal pancreatectomy. Surgical tissue examination confirmed the diagnosis of noninsulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) or nesidioblastosis. Initially after surgery the patient had full remission but after 6 months hypoglycemia recurred. However, this time it was well-controlled with octreotide treatment.


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