胰岛素瘤最初被误诊为偏头痛
Javeria Hameed1, Irbaz Ahmed2, Abed M Zaitoun3,4
1Department of Acute Medicine, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Archive of clinical cases
|October 2, 2025
概括
胰岛素瘤是一种罕见的胰腺瘤,导致低血糖症,在一个长期错误诊断症状的妇女身上被诊断出. 早期诊断和手术干预使她完全康复,这凸显了在神经糖发作中考虑胰岛素瘤的重要性.
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:
- 胰岛素瘤是一种罕见的胰腺神经内分泌瘤,导致胰岛素的过量产生.
- 症状包括神经糖和自主性问题,通常通过摄入葡萄糖来缓解.
- 延迟诊断可能导致严重的低血糖和并发症.
研究的目的:
- 报告胰岛素瘤病例,诊断延迟时间长.
- 强调早期胰岛素瘤诊断在患有复发性神经糖症状的患者中的重要性.
- 为了说明大胰岛素瘤的诊断途径和成功管理.
主要方法:
- 一个39岁妇女的病例报告,患有复发性低血糖症.
- 通过监督的72小时禁食,测量葡萄糖,C和胰岛素水平,通过生物化学确认.
- 图像学研究包括胰腺质量和68Ga-DOTATATE PET扫描.
- 切除的胰腺瘤的组织病理学分析.
主要成果:
- 该患者经历了近五年的错误诊断症状,然后因低血糖症而崩.
- 生物化学测试显示低血糖 (1.7mmol/L),升高的C- (2,271pmol/L) 和高胰岛素 (83.5 mU/L).
- 图像检测发现一个大,孤独的,增强胰腺质量,确认为1级神经内分泌瘤;没有检测到转移.
- 手术干预导致了成功的康复.
结论:
- 这一案例强调了将胰岛素瘤纳入复发性神经糖性发作的差异诊断的必要性.
- 早期发现和治疗胰岛素瘤可以预防严重的并发症和误诊.
- 及时的生化和成像评估对于及时诊断胰岛素瘤至关重要.
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