Takeda H, Watanabe K, Suzuki D, Miyano R, Tanaka K, Machimura H, Yagame M, Inoue W, Kaneshige H, Sakai H
Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Japan.
Tokai J Exp Clin Med. 1991 Mar;16(1):73-6.
A 72-year-old patient was referred to our hospital because of a hypoglycemic crisis possibly due to an insulin secreting-tumor. Although its localization was assumed to be at the head of the pancreas as assessed by transhepatic venography with sampling, no mass lesion was detected by selective angiography, ultrasound, computerized axial tomography, magnetic resonance imaging and 67Ga-citrate scan. The patient was treated with diazoxide, because of poor localization and his age, insulin secretion was improved after both 30 and 60 min in the 75 g oral glucose tolerance test. The total amount of urinary C-peptide excretion decreased from 70.8 to 29.2 mcg/day. Thereafter, no hypoglycemic symptoms were observed during his admission. No side effects except mild liver damage were observed.
一名72岁的患者因可能由胰岛素分泌肿瘤导致的低血糖危象被转诊至我院。尽管经肝静脉造影及采样评估，其肿瘤定位推测在胰头，但选择性血管造影、超声、计算机断层扫描、磁共振成像及枸橼酸镓扫描均未检测到肿块病变。由于定位困难及患者年龄因素，该患者接受了二氮嗪治疗，在75克口服葡萄糖耐量试验中，30分钟和60分钟后胰岛素分泌均得到改善。尿C肽排泄总量从70.8微克/天降至29.2微克/天。此后，患者住院期间未再出现低血糖症状。除轻度肝损伤外，未观察到其他副作用。
