Titre du document / Document title

Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery

Auteur(s) / Author(s)

SERVICE Geoffrey J. ⁽¹⁾ ; THOMPSON Geoffrey B. ⁽¹⁾ ; SERVICE F. John ⁽²⁾ ; ANDREWS James C. ⁽³⁾ ; COLLAZO-CLAVELL Maria L. ⁽²⁾ ; LLOYD Ricardo V. ⁽⁴⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Surgery, Mayo Clinic and Foundation, Rochester, Minn, ETATS-UNIS
⁽²⁾ Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic and Foundation, Rochester, Minn, ETATS-UNIS
⁽³⁾ Department of Radiology, Mayo Clinic and Foundation, Rochester, Minn, ETATS-UNIS
⁽⁴⁾ Department of Pathology, Mayo Clinic and Foundation, Rochester, Minn, ETATS-UNIS

Résumé / Abstract

We describe six patients (five women and one man; median age, 47 years; range, 39 to 54) with postprandial symptoms ofneuroglycopenia owing to endogenous hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass surgery. Except for equivocal evidence in one patient, there was no radiologic evidence ofinsulinoma. Selective arterial calcium-stimulation tests, positive in each patient, were used to guide partial pancreatectomy. Nesidioblastosis was identified in resected specimens from each patient, and multiple insulinomas were identified in one. Hypoglycemic symptoms diminished postoperatively. We speculate that hyperfunction of pancreatic islets did not lead to obesity but that beta-cell trophic factors may have increased as a result of gastric bypass.

Revue / Journal Title

The New England journal of medicine   ISSN 0028-4793   CODEN NEJMAG 

Source / Source

2005, vol. 353, n^o3, pp. 249-254 [6 page(s) (article)] (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

Massachusetts Medical Society, Boston, MA, ETATS-UNIS  (1928) (Revue)

Mots-clés anglais / English Keywords

Metabolic diseases ; Endocrinopathy ; Treatment ; Medicine ; Surgical anastomosis ; Bariatric surgery ; Hypoglycemia ; Hyperinsulinemia ;

Mots-clés français / French Keywords

Métabolisme pathologie ; Endocrinopathie ; Traitement ; Médecine ; Anastomose chirurgicale ; Chirurgie bariatrique ; Hypoglycémie ; Hyperinsulinémie ;

Mots-clés espagnols / Spanish Keywords

Metabolismo patología ; Endocrinopatía ; Tratamiento ; Medicina ; Anastomosis quirúrgica ; Cirurgia bariátrica ; Hipoglicemia ; Hiperinsulinemia ;

Localisation / Location

INIST-CNRS, Cote INIST : 6013, 35400013858577.0050