Insulinoma: A Rare Cause of Hypoglycemia in Childhood

Objective: Rare disease Background: Insulinomas are pancreatic neuroendocrine tumors that cause non-ketotic hypoglycemia due to hyperinsulinism; they are extremely rare, especially in children. Case Report: We present a case of a sporadic insulinoma in an 11-year-old boy who had episodes of self-lim...

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Authors: Escartin, R, Brun, N, Monforte, MNG, Ferreres, JC, Corripio, R
Format: article
Status:Published version
Publication Date:2018
Country:España
Institution:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repository:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p3974
Online Access:https://i3pt.portalinvestigacion.com/publicaciones/3974
Access Level:Open access
Keyword:Child
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Hyperinsulinism
Hypoglycemia
Insulinoma
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spelling Insulinoma: A Rare Cause of Hypoglycemia in ChildhoodEscartin, RBrun, NMonforte, MNGFerreres, JCCorripio, RChildEndoscopic Ultrasound-Guided Fine Needle AspirationHyperinsulinismHypoglycemiaInsulinomaObjective: Rare disease Background: Insulinomas are pancreatic neuroendocrine tumors that cause non-ketotic hypoglycemia due to hyperinsulinism; they are extremely rare, especially in children. Case Report: We present a case of a sporadic insulinoma in an 11-year-old boy who had episodes of self-limited drowsiness and behavior changes over a 3-month period, thought to be caused by psychological issues. Non-ketotic hypoglycemia was confirmed at our center. A fasting blood test found inappropriately elevated insulin levels during hypoglycemia, undetectable beta-hydroxybutyrate, and increased C-peptide levels in line with insulin levels. Anti-insulin antibodies were negative and antidiabetic drugs untraceable. The glucagon-stimulation test was positive. Growth hormone, adrenocorticotropin hormone, and phosphorus and calcium metabolism were normal. Dual-phase computed tomography detected a lesion compatible with an insulinoma. Endoscopic ultrasound showed a homogenous lesion at the junction of the body and tail of the pancreas. Histologic analysis of a fine-needle aspiration biopsy was compatible with neuroendocrine neoplasia. Preoperatively, a fractional diet avoiding fast-absorbing carbohydrates maintained normal glucose blood levels. Enucleation was not possible, so the lesion was resected along with portions of the body and tail of the pancreas. The well-differentiated tumor measured 15x13 mm. Postoperative blood glucose levels were correct, allowing a normal diet. Conclusions: In children with unspecific symptoms compatible with hypoglycemia, blood glucose must be evaluated to confirm low blood glucose levels. Determining blood ketone levels is important for the differential diagnosis. The diagnostic approach to pediatric insulinoma represents a challenge for multidisciplinary teamwork.INT SCIENTIFIC INFORMATION, INC2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/3974American Journal of Case ReportsISSN: 19415923reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p39742026-06-21T15:30:37Z
dc.title.none.fl_str_mv Insulinoma: A Rare Cause of Hypoglycemia in Childhood
title Insulinoma: A Rare Cause of Hypoglycemia in Childhood
spellingShingle Insulinoma: A Rare Cause of Hypoglycemia in Childhood
Escartin, R
Child
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Hyperinsulinism
Hypoglycemia
Insulinoma
title_short Insulinoma: A Rare Cause of Hypoglycemia in Childhood
title_full Insulinoma: A Rare Cause of Hypoglycemia in Childhood
title_fullStr Insulinoma: A Rare Cause of Hypoglycemia in Childhood
title_full_unstemmed Insulinoma: A Rare Cause of Hypoglycemia in Childhood
title_sort Insulinoma: A Rare Cause of Hypoglycemia in Childhood
dc.creator.none.fl_str_mv Escartin, R
Brun, N
Monforte, MNG
Ferreres, JC
Corripio, R
author Escartin, R
author_facet Escartin, R
Brun, N
Monforte, MNG
Ferreres, JC
Corripio, R
author_role author
author2 Brun, N
Monforte, MNG
Ferreres, JC
Corripio, R
author2_role author
author
author
author
dc.subject.none.fl_str_mv Child
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Hyperinsulinism
Hypoglycemia
Insulinoma
topic Child
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Hyperinsulinism
Hypoglycemia
Insulinoma
description Objective: Rare disease Background: Insulinomas are pancreatic neuroendocrine tumors that cause non-ketotic hypoglycemia due to hyperinsulinism; they are extremely rare, especially in children. Case Report: We present a case of a sporadic insulinoma in an 11-year-old boy who had episodes of self-limited drowsiness and behavior changes over a 3-month period, thought to be caused by psychological issues. Non-ketotic hypoglycemia was confirmed at our center. A fasting blood test found inappropriately elevated insulin levels during hypoglycemia, undetectable beta-hydroxybutyrate, and increased C-peptide levels in line with insulin levels. Anti-insulin antibodies were negative and antidiabetic drugs untraceable. The glucagon-stimulation test was positive. Growth hormone, adrenocorticotropin hormone, and phosphorus and calcium metabolism were normal. Dual-phase computed tomography detected a lesion compatible with an insulinoma. Endoscopic ultrasound showed a homogenous lesion at the junction of the body and tail of the pancreas. Histologic analysis of a fine-needle aspiration biopsy was compatible with neuroendocrine neoplasia. Preoperatively, a fractional diet avoiding fast-absorbing carbohydrates maintained normal glucose blood levels. Enucleation was not possible, so the lesion was resected along with portions of the body and tail of the pancreas. The well-differentiated tumor measured 15x13 mm. Postoperative blood glucose levels were correct, allowing a normal diet. Conclusions: In children with unspecific symptoms compatible with hypoglycemia, blood glucose must be evaluated to confirm low blood glucose levels. Determining blood ketone levels is important for the differential diagnosis. The diagnostic approach to pediatric insulinoma represents a challenge for multidisciplinary teamwork.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/3974
url https://i3pt.portalinvestigacion.com/publicaciones/3974
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv INT SCIENTIFIC INFORMATION, INC
publisher.none.fl_str_mv INT SCIENTIFIC INFORMATION, INC
dc.source.none.fl_str_mv American Journal of Case Reports
ISSN: 19415923
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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