Insulinoma may mask the existence of Type1 diabetes

Y. Oikawa, T. Katsuki, M. Kawasaki, A. Hashiguchi, K. Mukai, K. Handa, M. Tomita, Y. Kabeya, Y. Asai, K. Iwase, S. Hirose, K. Koyama, Y. Atsumi, A. Shimada

研究成果: Article査読

8 被引用数 (Scopus)

抄録

Background Insulinoma is a tumour of insulin-producing cells of the pancreas and is known to be one of the causes of hypoglycaemia. Usually, appropriate removal of the insulinoma results in normalization of blood glucose levels. However, we found novel cases of insulinoma, in which hyperglycaemia developed soon after resection of the insulinoma. Case report We encountered two patients with repeated hypoglycaemia caused by insulinoma. Following removal of the insulinoma, unanticipated hyperglycaemia was observed in both patients. Thereafter, their blood tests revealed low levels of serum C-peptide and high titres of anti-glutamic acid decarboxylase antibody, indicating concomitant Type1 diabetes. Indeed, histological examination of the resected specimen revealed that one patient showed insulitis in non-tumorous pancreatic tissue in which β-cells had already disappeared. Moreover, inflammatory cells infiltrated the insulinoma, as if it were insulitis of Type1 diabetes, suggesting the existence of anti-islet autoimmunity. Conclusion These are first cases of insulinoma associated with underlying Type1 diabetes. Physicians should be aware of the possibility that insulinoma may mask Type1 diabetes, and measurement of anti-islet autoantibodies may be helpful to find underlying Type1 diabetes, such as in these cases. It is pathologically interesting that the immune cell infiltration into insulinoma may be suggestive of anti-islet autoimmunity.

本文言語English
ページ(範囲)e138-e141
ジャーナルDiabetic Medicine
29
7
DOI
出版ステータスPublished - 2012 7月

ASJC Scopus subject areas

  • 内科学
  • 内分泌学、糖尿病および代謝内科学
  • 内分泌学

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