SUCCESSFUL TREATMENT OF PERSISTENT HYPERINSULINEMIC HYPOGLYCEMIA WITH NIFEDIPINE IN AN ADULT PATIENT
SUCCESSFUL TREATMENT OF PERSISTENT HYPERINSULINEMIC HYPOGLYCEMIA WITH NIFEDIPINE IN AN ADULT PATIENT
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DOI：
10.4158/ep09110.crr
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发表时间：
2010-01-01
影响因子：
4.2
通讯作者：
Mordes, John. P.
中科院分区：
文献类型：
--
作者：
Guseva, Nina;Phillips, David;Mordes, John. P.
目的：描述使用钙通道阻滞剂成功治疗一名曾接受过胃绕道手术的成年患者的严重非胰岛素血症高胰岛素性低血糖。方法：一名 65 岁女性，26 年前接受过胃绕道手术，因严重餐后低血糖而住院。住院期间和住院后，患者接受了葡萄糖、胰岛素、胰岛素原和 C 肽的常规测量评估，毒理学研究：胰腺的磁共振成像研究，以及选择性内脏动脉钙输注后肝静脉胰岛素浓度的测定结果：代谢变量与高胰岛素性低血糖的诊断一致磁共振成像显示存在稳定超过一年的侧支导管内乳头状粘液性肿瘤钙刺激胰岛素释放研究的结果与非局部胰岛素分泌过多一致频繁小量喂养的试验未能预防低血糖 根据儿童成纤维细胞增多症成功治疗的报告，患者随后服用米非地平，每天 30 毫克，随后她在 20 个月内没有出现症状性低血糖。 2010；16：107-111）。
Objective: To describe the successful treatment of severe noninsulinomia hyperinsulinemic hypoglycemia with use of a calcium channel blocking agent in an adult patient who had previously undergone a gastric bypass surgical procedure.Methods: A 65-year-old woman who had undergone a gastric bypass surgical procedure 26 years earlier was hospitalized because of severe postprandial hypoglycemia During and after hospitalization, the patient underwent assessment with conventional measurements of glucose, insulin, proinsulin, and C-peptide, toxicologic studies: magnetic resonance imaging studies of the pancreas, and determination of hepatic vein insulin concentrations after selective splanchnic artery calcium infusionResults: Metabolic variables were consistent with the diagnosis of hyperinsulimemic hypoglycemia Magnetic resonance imaging revealed the presence of a side branch intraductal papillary mucinous tumor that had been stable for more than 1 year The results of the calcium-stimulated insulin release study were consistent with nonlocalized hypersecretion of insulin A trial of frequent small feedings failed to prevent hypoglycemia On the basis of reports of successful treatment of childhood nesidioblastosis, the patient was then prescribed mfedipine, 30 mg daily She has subsequently remained free of symptomatic hypoglycemia for 20 monthsConclusion: A calcium channel blocking agent may be efficacious and a potential alternative to partial pancreatectomy in cases of noninsulionoma hyperinsulinemic hypoglycemia in adults (Endocr Pract. 2010;16:107-111).