PMID- 25926542
OWN - NLM
STAT- MEDLINE
DCOM- 20150827
LR  - 20150430
IS  - 0301-2603 (Print)
IS  - 0301-2603 (Linking)
VI  - 43
IP  - 5
DP  - 2015 May
TI  - [A Patient with Multiple Endocrine Neoplasia Type1(MEN1)Presenting with 
      Hypoglycemic Attacks].
PG  - 451-6
LID - 10.11477/mf.1436203045 [doi]
AB  - Here, we report the case of a woman with multiple endocrine neoplasia type 
      1(MEN1) who experienced hypoglycemic attacks. At the age of 59, she underwent 
      parathyroid tumor resection for hyperparathyroidism. At the age of 65, she 
      presented with dizziness at our hospital. Magnetic resonance imaging (MRI) 
      revealed a left cerebellopontine (CP) angle tumor and a pituitary tumor. The CP 
      angle tumor (acoustic neurionoma) was removed;the pituitary adenoma 
      (prolactinoma) was managed by using bromocriptine. At the age of 77, she lost 
      consciousness and was transferred to a local hospital. Her blood sugar level was 
      24 mg/dL. Due to the frequent recurrence of hypoglycemic attacks, she was 
      readmitted to our hospital. MRI revealed the almost complete removal of the 
      acoustic tumor and that her pituitary gland was atrophied. Despite her baseline 
      pituitary hormone levels being normal, we suspected panhypopituitarism and 
      administered cortisol (15 mg/day). As her hypoglycemia failed to improve, we 
      performed a 75-g oral glucose tolerance test, and its result was not indicative 
      of diabetes mellitus. Her pretest immunoreactive insulin (IRI) level was 
      6.8muU/mL;DeltaIRI/DeltaBS was 0.62, indicative of insulin hypersecretion. 
      Contrast-enhanced abdominal computed tomography revealed multiple pancreatic 
      tumors (insulinomas), and she underwent resection of the uncal tumor and pancreas 
      body and tail. Her postoperative IRI level was normalized and she experienced no 
      further hypoglycemic attacks. Based on her hyperparathyroidism, pancreatic tumor, 
      and pituitary adenoma, we diagnosed her with MEN1.
FAU - Bando, Kazuhiko
AU  - Bando K
AD  - Department of Neurosurgery, Anankyoei Hospital.
FAU - Ebisutani, Daizo
AU  - Ebisutani D
LA  - jpn
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - No Shinkei Geka
JT  - No shinkei geka. Neurological surgery
JID - 0377015
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - Blood Glucose/analysis
MH  - Female
MH  - Humans
MH  - Hypoglycemia/*etiology
MH  - Magnetic Resonance Imaging
MH  - Multimodal Imaging
MH  - Multiple Endocrine Neoplasia Type 1/*complications/*diagnosis/surgery
MH  - Pancreatic Neoplasms/*complications/*diagnosis/surgery
MH  - Tomography, X-Ray Computed
EDAT- 2015/05/01 06:00
MHDA- 2015/08/28 06:00
CRDT- 2015/05/01 06:00
PHST- 2015/05/01 06:00 [entrez]
PHST- 2015/05/01 06:00 [pubmed]
PHST- 2015/08/28 06:00 [medline]
AID - 1436203045 [pii]
AID - 10.11477/mf.1436203045 [doi]
PST - ppublish
SO  - No Shinkei Geka. 2015 May;43(5):451-6. doi: 10.11477/mf.1436203045.