Khan Md Ahmad R, Wazir Muhammad Hayyan, Waqar Salma, Ullah Rizwan, Gul Ayesha
Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Obstetrics and Gynecology, Mardan Medical Complex, Mardan, PAK.
Cureus. 2022 Mar 23;14(3):e23414. doi: 10.7759/cureus.23414. eCollection 2022 Mar.
Insulinoma is an insulin-secreting tumor that causes hypoglycemia due to inappropriately high insulin secretion. The Whipple's triad, which comprises indications of hypoglycemia (tremor, sweating, irritability, uneasiness, and weakness), plasma glucose concentration <55 mg/dL (3.0 mmol/L), and resolution of symptoms after administration of glucose, is utilized for the determination of insulinoma. In this report, we present the case of a thin, lean, adult male with a BMI of 22, who presented with repetitive episodes of tremor, sweating, weariness, and perplexity that occurred amid fasting and settled with meals, fulfilling Whipple's triad criteria for the determination of insulinoma. The episodes frequently led to seizures. Supervised fasting was carried out, which revealed raised C-peptide levels, low blood glucose, and negative sulfonylurea screen. A computed tomography (CT) scan localized the tumor, and surgical resection was planned.
胰岛素瘤是一种分泌胰岛素的肿瘤,由于胰岛素分泌过高且不恰当而导致低血糖。Whipple三联征包括低血糖的表现(震颤、出汗、易怒、不安和虚弱)、血浆葡萄糖浓度<55mg/dL(3.0mmol/L)以及给予葡萄糖后症状缓解,用于胰岛素瘤的诊断。在本报告中,我们介绍了一名体重指数为22的消瘦成年男性病例,他在禁食期间反复出现震颤、出汗、疲倦和困惑发作,进食后症状缓解,符合Whipple三联征诊断胰岛素瘤的标准。这些发作频繁导致癫痫发作。进行了监督性禁食,结果显示C肽水平升高、血糖降低且磺脲类筛查为阴性。计算机断层扫描(CT)扫描定位了肿瘤,并计划进行手术切除。