PMID- 28491431
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2055-1169 (Print)
IS  - 2055-1169 (Electronic)
IS  - 2055-1169 (Linking)
VI  - 2
IP  - 2
DP  - 2016 Jul-Dec
TI  - Hyperinsulinaemic, hypoglycaemic syndrome due to acquired nesidioblastosis in a 
      cat.
PG  - 2055116916657846
LID - 10.1177/2055116916657846 [doi]
LID - 2055116916657846
AB  - Case summary A 6-year-old, neutered female British Shorthair cat presented with 
      acute-onset weakness and mental dullness. Initially the cat was mildly 
      hyperglycaemic (9.9 mmol/l; reference interval [RI] 3.3-6.7 mmol/l). Over the 
      following 12 h the cat developed central blindness, tremors, intermittent 
      seizures and opisthotonus. Repeat blood sampling revealed a marked hypoglycaemia 
      (0.8 mmol/l). Insulin level (performed on a serum sample collected while the cat 
      was hypoglycaemic) was inappropriately elevated (1575 mIU/l; RI 10-80 mIU/l). An 
      abdominal ultrasound was unremarkable. An exploratory laparotomy revealed a firm 
      and erythematous left limb of the pancreas. Following surgical resection of the 
      left limb of the pancreas, the cat returned to a euglycaemic state after a brief 
      rebound hyperglycaemia. Histopathology revealed pancreatic fibrosis with marked 
      multifocal micronodular hyperplasia of exocrine and endocrine cells. 
      Synaptophysin immunohistochemistry confirmed nodular beta-cell hyperplasia. 
      Relevance and novel information Nesidioblastosis describes a syndrome of acquired 
      hyperinsulinaemia and associated hypoglycaemia secondary to focal or diffuse 
      (non-neoplastic) beta-cell hyperplasia within the pancreas. Acquired 
      nesidioblastosis has been reported in humans, where beta-cell dysregulation is 
      thought to occur in response to pancreatic injury. This is the first reported 
      case of clinically significant hypoglycaemia due to acquired nesidioblastosis in 
      an adult domestic cat. While this condition is rare, nesidioblastosis is being 
      increasingly recognised in humans and it is an important differential diagnosis 
      to consider when investigating hypoglycaemia as it cannot be distinguished from 
      insulinoma without histopathological evaluation. While recurrence has been 
      occasionally reported in humans, the prognosis is considered good.
FAU - Hambrook, Lydia E
AU  - Hambrook LE
AD  - Small Animal Medicine Department, Advanced Vetcare, Melbourne, VIC, Australia.
FAU - Ciavarella, Amanda A
AU  - Ciavarella AA
AD  - Small Animal Medicine Department, Advanced Vetcare, Melbourne, VIC, Australia.
FAU - Nimmo, Judith S
AU  - Nimmo JS
AD  - Australian Specialised Animal Pathology Laboratory, Melbourne, VIC, Australia.
FAU - Wayne, Julie
AU  - Wayne J
AD  - Australian Specialised Animal Pathology Laboratory, Melbourne, VIC, Australia.
LA  - eng
PT  - Case Reports
DEP - 20160707
PL  - England
TA  - JFMS Open Rep
JT  - JFMS open reports
JID - 101672978
PMC - PMC5362857
COIS- Conflict of interest: The authors declared no potential conflicts of interest 
      with respect to the research, authorship, and/or publication of this article.
EDAT- 2017/05/12 06:00
MHDA- 2017/05/12 06:01
PMCR- 2016/07/07
CRDT- 2017/05/12 06:00
PHST- 2016/06/06 00:00 [accepted]
PHST- 2017/05/12 06:00 [entrez]
PHST- 2017/05/12 06:00 [pubmed]
PHST- 2017/05/12 06:01 [medline]
PHST- 2016/07/07 00:00 [pmc-release]
AID - 10.1177_2055116916657846 [pii]
AID - 10.1177/2055116916657846 [doi]
PST - epublish
SO  - JFMS Open Rep. 2016 Jul 7;2(2):2055116916657846. doi: 10.1177/2055116916657846. 
      eCollection 2016 Jul-Dec.