ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Difficulties In Diagnosis And Treatment In Cases With Neuroglycopenia Symptoms: A Case Of Insulinoma
Dr.Taner BAYRAKTAROĞLU,a Dr.Sinan TRABLUS,b Dr.Ali BORAZAN,a Dr.Can DAVUTOĞLU,c Dr.Mehmet Ali GÜRSOY,d Dr.Esra GÜRSOY,e Dr.Adnan ERİMf
aİç Hastalıkları AD, Zonguldak Karaelmas Üniversitesi Tıp Fakültesi, ZONGULDAKbİç Hastalıkları Kliniği, İstanbul SSK Samatya Hastanesi cİç Hastalıkları Kliniği, dGenel Cerrahi Kliniği, eNöroloji Kliniği, fPatoloji Kliniği, Vakıf Gureba Eğitim Hastanesi, İSTANBUL
A 47 year-old female patient presented with complaints of strabismus, sweating, enuresis tongue biting and repetitive fainting in the last 6 months. She had no history of diabetes. A blood glucose level measured during an acute episode was 30 mg/dL. In the oral glucose tolerance test, the blood glucose level at 3 h was found to be with 44 mg/dL and the signs of hypoglycemia were detected. Simultaneously measured insulin and C-peptide levels were found to be high at 36 U/ml (1-25 U/ml) and 6.2 ng/ml (0.9-4 ng/ml), respectively). On the examination of the upper abdomen using magnetic resonance imaging, a suspicious nodular area with approximately 2cm of contrast involvement was detected neighboring the inferomedial side of the uncinate process of the pancreas. By selective celiac angiography, a solid nodular mass with a hypervascular character located in the head of pancreas was detected. The tumoral mass was excised and tissue of solitary structure with no glandular structure was observed in the pathology. It stained positively with synaptophysine, neuronspecific enolase, chromogranine and insulin.
In the differential diagnosis of the patients with serious neuroglycopenic symptoms without diabetes history, insulinoma should always be considered.Keywords: Hypoglycemia, neuroglycopenic symptoms, insulinomaTurkiye Klinikleri J Med Sci 2004, 24:101-105
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