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非岛状细胞瘤低血糖症:一种罕见的神经瘤综合征

Aishwarya Gaur¹, Shyam Sunder², Prabhat Narain Sharma³

¹Resident, DNB Medicine, Department of General Medicine, Employees' State Insurance Corporation Model Hospital, Jaipur, Rajasthan, India.

The Journal of the Association of Physicians of India

|February 10, 2025

概括

非小岛细胞瘤低血糖症 (NICTH) 是一种罕见的疾病,由过多的胰岛素样生长因子2 (IGF-2) 引起. 这个案例突出了一个年轻的男性胆囊质量的独特呈现,强调了超越胰岛素瘤的诊断考虑.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
胃肠病学胃肠病学

背景情况:

非小岛细胞瘤低血糖症 (NICTH) 是一种罕见的低血糖症原因,通常与产生过多胰岛素样生长因子2 (IGF-2) 的恶性瘤有关.
诊断通常涉及高的IGF-2/IGF-1比率,手术作为主要治疗和葡萄糖皮质激素作为替代.
NICTH可能会被误认为是低血糖的更常见原因,需要彻底的诊断方法.

研究的目的:

为了在一个年轻的男性中呈现一个独特的NICTH病例,该年轻男性患有胆囊穴质.
突出NICTH的诊断挑战和考虑因素,特别是当常见原因被排除在外时.
强调在患有不明原因低血糖症和特定瘤标志物的患者中考虑NICTH的重要性.

主要方法:

一个27岁的男性患有慢性乙型肝炎的病例报告,呈现严重的低血糖症.
诊断工作包括评估胰岛素,C-,IGF-1,IGF-2和垂体功能.
对胆囊质量进行了免疫组织化学 (IHC) 分析.

主要成果:

该患者出现了复发性,严重的低血糖症,胰岛素和C-水平受到抑制.
实验室发现显示IGF-1受抑制,IGF-2/IGF-1比率升高,表明NICTH.
胆囊体被确定为IGF-2过度产生的可能来源.

结论:

这一案例强调了在低血糖症的差异诊断中考虑NICTH的重要性,即使在年轻患者和异常瘤位置的情况下也是如此.
临床医生应该怀疑NICTH,当标准低血糖症工作是不确定的,IGF-2水平升高.
及时诊断和管理,可能涉及手术,对于改善NICTH患者的治疗结果至关重要.

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