Nesidioblastosis Associated with Insulin-mediated Hypoglycemia in an Adult
Nesidioblastosis Associated with Insulin-mediated Hypoglycemia in an Adult
复制标题
成纤维细胞增多症与成人胰岛素介导的低血糖有关
作者：
D. Nathan;L. Axelrod;K. Proppe;R. Wald;H. Hirsch;D. Martin
Nesidioblastosis是胰岛从导管上皮分化的过程，是新生儿和婴儿胰岛素介导的低血糖的一个很好的原因，但在成人中没有。一名58岁女性，具有空腹低血糖的典型临床特征，在空腹低血糖的症状发作期间，血浆免疫反应性胰岛素水平不适当升高。血管造影、开腹触诊、胰腺远端四分之三切除均未发现肿瘤。病理检查发现胰腺成瘤细胞，即胰岛从小管壁出芽，胰岛数量和大小增加，形状和位置异常。包括nesidioblastosis在内的一系列胰岛细胞异常可导致成人胰岛素介导的低血糖，正如它在新生儿和婴儿中所做的那样。
Nesidioblastosis, the process of differentiation of pancreatic islets from ductular epithelium, is a well-described cause of insulin-mediated hypoglycemia in neonates and infants, but not in adults. A 58-yr-old woman with characteristic clinical features of fasting hypoglycemia had inappropriately elevated plasma immunoreactive insulin levels during symptomatic episodes of fasting hypoglycemia. Angiography, palpation at laparotomy, and resection of the distal three-quarters of the pancreas provided no evidence of a tumor. Pathologic examination of the resected pancreas revealed the findings of nesidioblastosis, i.e., budding of islets from the wall of ductules, and also increased number and size of islets and abnormal shape and location of islets. An entire spectrum of islet cell abnormalities including nesidioblastosis can cause insulin-mediated hypoglycemia in adults, as it does in neonates and infants.