Paladugu Niranjana Rekha, Vukkadala Muralinath, Das Anshuman, Sekaran Anuradha, Merugu Chandhana
Department of Nephrology, Asian Institute of Gastroenterology (AIG) (Mayo clinic care network) Hospitals, Hyderabad, Telangana, India.
Department of Pathology, Asian Institute of Gastroenterology (AIG) (Mayo clinic care network) Hospitals, Hyderabad, Telangana, India.
Indian J Nephrol. 2025 May-Jun;35(3):433-434. doi: 10.25259/IJN_90_2024. Epub 2024 Jun 24.
We report a rare and intricate case of nesidioblastosis, marked by hyperinsulinemic hypoglycemia, in a patient with diabetes and chronic kidney disease (CKD). PET-CT imaging and histopathology confirmed the condition, culminating in a comprehensive treatment strategy comprising subtotal pancreatectomy and pharmacotherapy. This case marks the first documented occurrence of nesidioblastosis in a patient with CKD and diabetes. The presence of CKD further complicated the clinical picture, influencing hypoglycemic risk, drug efficacy, insulin clearance, and counter-regulatory mechanisms.
我们报告了一例罕见且复杂的胰岛细胞增殖症病例，该病例以高胰岛素血症性低血糖为特征，患者患有糖尿病和慢性肾脏病（CKD）。正电子发射断层扫描-计算机断层扫描（PET-CT）成像和组织病理学证实了该病症，最终形成了包括胰腺次全切除术和药物治疗的综合治疗策略。该病例是首次有文献记载的CKD和糖尿病患者发生胰岛细胞增殖症的病例。CKD的存在使临床情况更加复杂，影响了低血糖风险、药物疗效、胰岛素清除率和反调节机制。
