인슐린종과 자가면역성 저혈당을 모방한 성인 랑게르한스 섬모세포 증식증 1예
A case of adult nesidioblastosis mimicking an insulinoma and autoimmune hypoglycemia
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초록
저자들은 성인에서 드물게 나타나는 랑게르한스 섬모세포 증식증이 수술 전 인슐린종과 자가면역성 저혈당을 시사하는 검사결과 및 환자의 당뇨병을 차폐하는 임상양상을 보인 증례를 경험하였기에 이를 보고하는 바이다.
Abstract
Hyperinsulinemic hypoglycemia in the absence of exogenous insulin use is caused by disorders such as insulinoma, diffuse β- cell hyperplasia/nesidioblastosis, and autoimmune hypoglycemia. Nesidioblastosis is a rare cause of hypoglycemia in adults, accounting for 0.5~7.0% of organic hyperinsulinemia cases. Although pancreatic resection is considered the best treatment modality for curing nesidioblastosis, there is no consensus regarding the indications for and extent of the surgery due to its high risk and complication rate. A 75-year-old woman presented with an altered mental state, a mass suspected of being an insulinoma, and insulin receptor antibodies. The patient underwent surgery because of recurrent life-threatening hypoglycemia. Postoperative pathology of her pancreas revealed nesidioblastosis.
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