P04 | When hypoglycemia becomes a real challenge for the internist
Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Insulinoma is a neuroendocrine tumor characterized by overproduction of insulin which causes hypoglycema which can be fatal. The incidence is of 1 case per million/year. Case presentation: A 17-yrs-old girl is found unconscious, unresponsive, with no sphincter release. At the emergency department hypoglycemia (25mg/dl) was found. In history: previous rheumatic disease. Several episodes of hypoglycemia were observed during hospitalization; pharmacological causes were excluded; blood tests showed: increased levels of C-peptide (5.83 ng/ml) and insulin (54.5 IU/mL), instead normal values of GH, IGF1, cortisoluria, cortisol, thyroid, liver and kidney function, autoimmunity was negative (antiGAD, antidecarboxylase of glutamic acid, anti-insulin, antiZnT8, antiIA2, anti tyrosine phosphatase). After starting a therapy with diazzoxide we monitored glycemic values using a glucose sensor and we observed normal glicemia. An abdominal MRI showed no pancreatic lesions but glucagon test after prolonged fasting was positive so we performed a PET scan with 68GA-DOTATOC receptor tracer with up-take at the level of the pancreatic body. Echoendoscopy with biopsy showed histology compatible with isulinoma. Patient underwent surgery. Conclusions: Hypoglycemia is challenge in Internal Medicine. One of the causes of hypoglycemia is insulinoma. Knowing the correct diagnostic procedure can help the clinician make a diagnosis more quickly and save the patient from life-threatening hypoglycemic crises.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413795090