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Multiple endocrine adenomatosis type I in pregnancy
A R Smythe1, K F McFarland, M Yousufuddin
1Department of Obstetrics and Gynecology, Baptist Medical Center, Columbia, SC.
American Journal of Obstetrics and Gynecology
|September 1, 1990
Summary
A pregnant woman experienced severe hypoglycemia due to an insulinoma, a rare pancreatic tumor. Diagnosis was confirmed post-delivery, revealing a case of multiple endocrine neoplasia type I.
Area of Science:
- Endocrinology
- Oncology
- Obstetrics
Background:
- Pregnancy can present diagnostic challenges for rare endocrine disorders.
- Insulinomas, though rare, can cause severe hypoglycemia.
- Multiple Endocrine Neoplasia type I (MEN1) involves tumors in multiple endocrine glands.
Observation:
- A 26-year-old pregnant woman presented with recurrent severe hypoglycemia, confusion, slurred speech, and blurred vision.
- Despite intravenous glucose, hypoglycemia persisted postpartum, necessitating further investigation.
- Pancreatic arteriography identified a pancreatic tail mass, later confirmed as an insulinoma.
Findings:
- The patient was diagnosed with an insulinoma causing severe hypoglycemia during and after pregnancy.
- Post-surgical evaluation revealed hypercalcemia and elevated parathyroid hormone levels.
- A family history of hyperparathyroidism suggested Multiple Endocrine Neoplasia type I (MEN1).
Implications:
- This case highlights the importance of considering rare endocrine disorders in pregnant patients with unexplained symptoms.
- Early diagnosis and management of insulinoma are crucial for maternal and fetal well-being.
- The diagnosis of MEN1 has significant implications for long-term patient management and family screening.