Hercus Jess C, Pasha Pouneh, Al Lawati Sadiq, Kim Peter, Mattman Andre, Webber Douglas, Thompson David M
Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Division of Internal Medicine, Department of Medicine, University of British Columbia, 5913-1081 Burrard St., Vancouver, British Columbia V6Z 1Y6, Canada.
Case Rep Endocrinol. 2022 Oct 7;2022:2802975. doi: 10.1155/2022/2802975. eCollection 2022.
Nesidioblastosis is a rare pancreatic disorder involving enlarged beta cells throughout the pancreas, causing elevated insulin production. We present the case of a 53-year-old woman with the initial symptom of fasting hypoglycemia. No pancreatic lesions were indicated on computed tomography and magnetic resonance imaging scans, and an octreotide scan was negative for insulinoma. Selective arterial calcium stimulation (SACST) showed increased insulin production from the stimulation of 3 out of 5 arteries. The SACST results suggested a diagnosis of nesidioblastosis, which was confirmed by histopathology after a subtotal distal pancreatectomy. The patient has normal glucose tolerance after surgery with no further problems of hypoglycemia, indicating that this is a rare case of nesidioblastosis extending only partially through the pancreas.
胰岛细胞增殖症是一种罕见的胰腺疾病，其特征是整个胰腺的β细胞增大，导致胰岛素分泌增加。我们报告一例53岁女性患者，其首发症状为空腹低血糖。计算机断层扫描和磁共振成像扫描均未显示胰腺病变，奥曲肽扫描未发现胰岛素瘤。选择性动脉钙刺激试验（SACST）显示，5条动脉中有3条受到刺激后胰岛素分泌增加。SACST结果提示胰岛细胞增殖症的诊断，远端胰腺次全切除术后的组织病理学检查证实了这一诊断。患者术后糖耐量正常，未再出现低血糖问题，表明这是一例仅部分胰腺受累的罕见胰岛细胞增殖症病例。
