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Related Experiment Videos

An insulinoma without fasting hypoglycemia.

R M Jordan, H Kammer

    The American Journal of the Medical Sciences
    |September 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    This case study highlights an insulinoma diagnosis in a patient with episodic neurological symptoms. Despite prolonged fasting, the patient tolerated it, suggesting elevated proinsulin-like components (PLC) contributed to the immunoreactive insulin (IRI) levels.

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    Area of Science:

    • Endocrinology
    • Oncology
    • Gastroenterology

    Background:

    • Episodic neurological symptoms including irritability, confusion, and unconsciousness over 25 years suggested organic hypoglycemia.
    • Standard diagnostic protocols for hypoglycemia, such as prolonged fasting, were employed.

    Observation:

    • A 72-hour fast did not precipitate hypoglycemic symptoms in the patient.
    • Post-fasting blood glucose was 85 mg/100 ml, with elevated immunoreactive insulin (IRI) at 350 microunits/ml.

    Findings:

    • Surgical exploration revealed a 4 x 3 cm insulinoma in the pancreatic tail.
    • Elevated IRI levels were attributed to proinsulin-like components (PLC), which have reduced biologic activity compared to insulin.

    Implications:

    Related Experiment Videos

    • The inability to withstand prolonged fasting does not rule out an insulinoma diagnosis.
    • Elevated PLC may represent a mechanism allowing some patients with insulinoma to tolerate fasting periods.