Insulinoma Presenting as Seizures: Challenges of Managing a Rare Disease in a Resource-challenged Setting.

Autor: Soyoye DO; Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun 220282, Nigeria.; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife 220213, Nigeria., Atolani SA; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife 220213, Nigeria., Adetunji TA; Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun 220282, Nigeria.; Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife 220213, Nigeria., Alatise OI; Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun 220282, Nigeria.; Department of Surgery, Obafemi Awolowo University Teaching Hospital, Ile-Ife 220213, Nigeria.
Jazyk: angličtina
Zdroj: JCEM case reports [JCEM Case Rep] 2023 Dec 19; Vol. 2 (1), pp. luad162. Date of Electronic Publication: 2023 Dec 19 (Print Publication: 2024).
DOI: 10.1210/jcemcr/luad162
Abstrakt: Insulinomas are functioning pancreatic neuroendocrine tumors (NETs). They secrete insulin, and hence, present with hypoglycemia. We report a case of insulinoma in a 16-year-old girl presenting as seizures. She was initially managed at a private clinic and later commenced on carbamazepine when convulsion persisted. Convulsions were generalized, associated with dizziness and altered sensorium, often preceded by hunger and physical exertion, but relieved by the intake of carbonated drinks and fruit juice. She was referred to the neurology clinic when seizures persisted, despite the use of anticonvulsant. She was later referred to the endocrine clinic on suspicion of insulinoma when her random blood glucose (BG) was found to be low during an episode of convulsion. She was moderately obese but other examination findings were normal. She had a 72-hour prolonged fast, which was terminated when hypoglycemia (BG = 2.2 mmol/L) ensued after 12 hours, with elevated serum insulin and C-peptide. Abdominal magnetic resonance imaging scan showed a pancreatic tumor suggestive of insulinoma. She subsequently had distal pancreatectomy performed with complete resolution of symptoms. Unusual presentation of insulinoma may delay diagnosis, resulting in wastage of resources with increased morbidities and mortality.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze: MEDLINE
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