Wong Mimi, Conway Luke, Cooper Caroline, Sinha Ashim, Nandi Nirjhar
AACE Clin Case Rep. 2019 Aug 14;5(6):e375-e379. doi: 10.4158/ACCR-2019-0243. eCollection 2019 Nov-Dec.
Adult nesidioblastosis is characterized by endogenous hyperinsulinemia typically causing post-prandial hypoglycemia, and most commonly occurs post-Roux-en-Y gastric bypass.
We report a unique case of nesidioblastosis occurring in a 67-year-old female.
A 5-year history of symptomatic hypoglycemia occurred in a patient with short bowel syndrome and type 2 diabetes mellitus (T2DM) managed previously with a glucagon-like peptide 1 (GLP-1) agonist, which achieved significant weight loss. Continuous glucose monitoring captured 42 hypoglycemia episodes in a 2-week period, and following an oral glucose tolerance test there was the suggestion of a hyperinsulinemia state. She was managed with an open distal pancreatectomy, and subsequently required medical therapy to maintain euglycemia.
We present the first case of nesidioblastosis occurring in a patient with short bowel syndrome, pre-existing T2DM managed with a GLP-1 agonist which achieved significant weight loss, all of which we speculate could have predisposed to hypoglycemia and development of nesidioblastosis.
成人胰岛细胞增殖症的特征是内源性高胰岛素血症，通常导致餐后低血糖，最常见于胃旁路手术后。
我们报告了一例发生在67岁女性身上的胰岛细胞增殖症罕见病例。
一名患有短肠综合征和2型糖尿病（T2DM）的患者有5年的症状性低血糖病史，此前使用胰高血糖素样肽1（GLP-1）激动剂治疗，体重显著减轻。连续血糖监测在2周内捕捉到42次低血糖发作，口服葡萄糖耐量试验后提示存在高胰岛素血症状态。她接受了开放性远端胰腺切除术，随后需要药物治疗以维持血糖正常。
我们报告了首例发生在短肠综合征患者身上的胰岛细胞增殖症病例，该患者既往患有T2DM，使用GLP-1激动剂治疗后体重显著减轻，我们推测所有这些因素都可能导致低血糖和胰岛细胞增殖症的发生。
