Publicação
Caso clínico de proinsulinoma e breve revisão de hipoglicémia
| Resumo: | There are several pathological entities responsible for signs of hypoglycaemia, and quite frequently have to be dealt with at the hospital, on a daily basis. The author presents a case of a female patient, 64 years old, with complaints of visual changes, mental confusion, profuse sweating and trembling of the hands, which manifested itself in situations of prolonged fasting and disappeared after food intake. The patient was submitted to a prolonged fasting test and after seventeen hours presented the symptoms described with hypoglycemia of 40 mg/dL (normal range: 75-100 mg/dL), and normal levels of insulin: 6,8 U/mL (normal range: 3-25 U/mL) and C-peptide: 1,8 ng/dL (reference value: 0,9-4,0 ng / dL). In a second test, with comparable results, a measurement of proinsulin (reference value <9.4 pmol / L) was performed, showing high levels of this molecule: 143 pmol/L. It was performed an endoscopic ultrasound which revealed a pancreatic nodule of 12x8mm. Subsequently, the patient underwent laparotomy with corpocaudal pancreactetomia. Histological analysis confirmed the presence of a well-differentiated tumor cells with insulin immunoreactivity. After intervention, the patient remained without complaints and normal serum glucose levels.Concerning this case report, it is presented a brief review of the differential diagnosis of hypoglycemia. |
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| Autores principais: | Mano, Sofia Costa de Sousa |
| Assunto: | Proinsulinoma Hipoglicémia Endocrinologia |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | There are several pathological entities responsible for signs of hypoglycaemia, and quite frequently have to be dealt with at the hospital, on a daily basis. The author presents a case of a female patient, 64 years old, with complaints of visual changes, mental confusion, profuse sweating and trembling of the hands, which manifested itself in situations of prolonged fasting and disappeared after food intake. The patient was submitted to a prolonged fasting test and after seventeen hours presented the symptoms described with hypoglycemia of 40 mg/dL (normal range: 75-100 mg/dL), and normal levels of insulin: 6,8 U/mL (normal range: 3-25 U/mL) and C-peptide: 1,8 ng/dL (reference value: 0,9-4,0 ng / dL). In a second test, with comparable results, a measurement of proinsulin (reference value <9.4 pmol / L) was performed, showing high levels of this molecule: 143 pmol/L. It was performed an endoscopic ultrasound which revealed a pancreatic nodule of 12x8mm. Subsequently, the patient underwent laparotomy with corpocaudal pancreactetomia. Histological analysis confirmed the presence of a well-differentiated tumor cells with insulin immunoreactivity. After intervention, the patient remained without complaints and normal serum glucose levels.Concerning this case report, it is presented a brief review of the differential diagnosis of hypoglycemia. |
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