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Nesidioblastosis in an elderly patient
D Walmsley1, N A Matheson, S Ewen
1Department of Endocrinology, Aberdeen Royal Infirmary, UK.
Summary
An 84-year-old woman experienced hypoglycemia and hyperinsulinism due to diffuse nesidioblastosis, the oldest recorded case. This highlights diagnostic challenges and surgical benefits in elderly patients with unexplained hyperinsulinism.
Area of Science:
- Endocrinology
- Gastroenterology
- Geriatric Medicine
Background:
- Nesidioblastosis, a rare cause of hyperinsulinemic hypoglycemia, typically affects younger individuals.
- Diagnosing inappropriate hyperinsulinism can be challenging, especially in elderly patients with non-specific symptoms.
Observation:
- An 84-year-old female presented with symptomatic hypoglycemia and hyperinsulinism.
- Histopathological examination revealed diffuse nesidioblastosis as the underlying cause.
- This represents the oldest documented case of nesidioblastosis.
Findings:
- The patient's condition was successfully managed with surgical intervention.
- The case underscores the diagnostic difficulties associated with hyperinsulinemic hypoglycemia in the elderly.
- Variable mental function in older adults warrants consideration for hypoglycemia.
Implications:
- Surgical treatment for nesidioblastosis can be effective even in advanced age.
- Increased awareness of nesidioblastosis is crucial for timely diagnosis and management.
- This case expands the known age range for nesidioblastosis and its surgical treatability.
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