Harada Ko, Hanayama Yoshihisa, Hasegawa Kou, Iwamuro Masaya, Hagiya Hideharu, Yoshida Ryuichi, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Intern Med. 2017;56(4):413-417. doi: 10.2169/internalmedicine.56.7758. Epub 2017 Feb 15.
Insulinoma is a rare, usually benign, pancreatic neuroendocrine tumor. The clinical features of an insulinoma are fasting hypoglycemia with neuroglycopenic symptoms including confusion and unusual behavior, while hypertension is usually not associated with the disease. We herein report a patient with insulinoma who manifested paroxysmal hypertension and neuroglycopenic symptoms. The possible etiology of hypertension induced by an insulinoma is catecholamine release in response to hypoglycemia, which may cause acute hypertension through activation of the sympatho-adrenal system. This case implies that sustained hyperinsulinemia due to insulinoma can be functionally linked to the induction of paroxysmal hypertension.
胰岛素瘤是一种罕见的、通常为良性的胰腺神经内分泌肿瘤。胰岛素瘤的临床特征是空腹低血糖伴神经低血糖症状，包括意识模糊和异常行为，而高血压通常与该疾病无关。我们在此报告一例胰岛素瘤患者，该患者表现为阵发性高血压和神经低血糖症状。胰岛素瘤所致高血压的可能病因是低血糖反应引起的儿茶酚胺释放，这可能通过激活交感-肾上腺系统导致急性高血压。该病例提示，胰岛素瘤所致的持续性高胰岛素血症可能在功能上与阵发性高血压的诱发有关。
