PMID- 37908256
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231102
IS  - 2755-1520 (Electronic)
IS  - 2755-1520 (Linking)
VI  - 1
IP  - 1
DP  - 2023 Jan
TI  - Insulinoma Presenting With Postprandial Hypoglycemia in a Pregnant Woman With 
      MEN-1.
PG  - luac015
LID - 10.1210/jcemcr/luac015 [doi]
LID - luac015
AB  - Insulinomas are rare insulin-secreting tumors of pancreatic origin that cause 
      hypoglycemia and can be associated with multiple endocrine neoplasia type 1 
      (MEN1). While rare, they are the most common cause of hypoglycemia related to 
      endogenous hyperinsulinism. A 28-year-old woman with known MEN1 presented with 
      postprandial hypoglycemia in the second trimester of pregnancy. Prior to her 
      presentation she was known to have several pancreatic neuroendocrine tumors that 
      had been stable on serial imaging, but no history of hypoglycemia. She was 
      managed with dietary intervention during pregnancy and gave birth to a healthy 
      baby at 37 weeks' gestation. After pregnancy, hypoglycemia initially resolved, 
      but then recurred at 8 months post partum. Magnetic resonance imaging showed 
      several pancreatic neoplasms with the largest lesion measuring 29 mm in the 
      pancreatic tail, unchanged from previous imaging. After localization with a 
      selective arterial calcium stimulation test, the patient underwent successful 
      distal pancreatectomy with resolution of symptoms. This case is unusual in that 
      her initial presentation was during pregnancy, she had predominantly postprandial 
      rather than fasting hypoglycemia, and her symptoms remitted for several months 
      after delivery. Key learning points are to have a low index of suspicion for an 
      insulinoma when there is a history of MEN1 and the need for a pragmatic approach 
      to diagnosis and treatment during pregnancy.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the 
      Endocrine Society.
FAU - Wood, Anna J
AU  - Wood AJ
AUID- ORCID: 0000-0002-7648-8925
AD  - Department of Endocrinology, Royal Darwin Hospital, Casuarina, Northern Territory 
      0810, Australia.
AD  - Menzies School of Health Research , Charles Darwin University, Casuarina, 
      Northern Territory, Australia.
FAU - Kasireddy, Vidya
AU  - Kasireddy V
AD  - Department of Endocrinology, Royal Darwin Hospital, Casuarina, Northern Territory 
      0810, Australia.
FAU - Chitturi, Sridhar
AU  - Chitturi S
AD  - Department of Endocrinology, Royal Darwin Hospital, Casuarina, Northern Territory 
      0810, Australia.
AD  - School of Medicine, Flinders University, Northern Territory Medical Program, 
      Tiwi, Northern Territory, Australia.
FAU - Walsh, John P
AU  - Walsh JP
AD  - Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 
      Nedlands, Australia.
AD  - Medical School, University of Western Australia, Crawley, Australia.
LA  - eng
PT  - Case Reports
DEP - 20221130
PL  - England
TA  - JCEM Case Rep
JT  - JCEM case reports
JID - 9918609886906676
PMC - PMC10578399
OTO - NOTNLM
OT  - hypoglycemia
OT  - insulinoma
OT  - multiple endocrine neoplasia type 1 (MEN1)
OT  - pregnancy
EDAT- 2023/11/01 06:43
MHDA- 2023/11/01 06:44
PMCR- 2022/11/30
CRDT- 2023/11/01 03:49
PHST- 2022/09/07 00:00 [received]
PHST- 2023/11/01 06:44 [medline]
PHST- 2023/11/01 06:43 [pubmed]
PHST- 2023/11/01 03:49 [entrez]
PHST- 2022/11/30 00:00 [pmc-release]
AID - luac015 [pii]
AID - 10.1210/jcemcr/luac015 [doi]
PST - epublish
SO  - JCEM Case Rep. 2022 Nov 30;1(1):luac015. doi: 10.1210/jcemcr/luac015. eCollection 
      2023 Jan.