Successful treatment of adult‐onset nesidioblastosis by continuous subcutaneous octreotide infusion in a patient on hemodialysis

Kato, Ryuichi; Nishimura, Akihiro; Matsumura, K.; Kikuno, Shota; Nagasawa, Kaoru; Mori, Yusaku

doi:10.1002/ccr3.3514

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…Medical management with acarbose, diazoxide, verapamil, or octreotide is the next step in therapy for those who fail or are unable to continue with conservative management and have persistent hypoglycemia symptoms. There are clinical case reports that have demonstrated improved symptoms with medical management alone in patients with post-RYGB hypoglycemia [ 14 - 17 ]. For patients with severe postprandial hypoglycemia or symptoms refractory to medical treatment, surgical management with partial or subtotal pancreatectomy is the therapy of choice; however, there have been reported cases of recurrent hypoglycemia requiring total pancreatectomy [ 18 - 19 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Translational Science, Continuous Glucose Monitoring in the Primary Care Setting for Management of Nesidioblastosis: A Case Report and Literature Review

Manandhar,

Farahneh,

Damlakhy

et al. 2024

Cureus

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Nesidioblastosis is a term used to describe histologic changes in the pancreatic cell, which are defined by beta cell hypertrophy and the formation of ductoinsular complexes. It is a disease previously most extensively identified in neonates and is a rare cause of endogenous hypoglycemia in the adult population. However, with increasing numbers of gastric bypass surgeries for the management of obesity in recent years, there has been a growing number of populations with post-gastric bypass surgery-related nesidioblastosis. Here, we will present a case of a 60-year-old female with a history of Roux-en-Y gastric bypass (RYGB) surgery who initially presented with loss of consciousness and episodes of suspected hypoglycemia. Insulinoma was ruled out, supporting the diagnosis of adult onset RYGB-associated nesidioblastosis.This article was previously presented as a poster presentation at the 2023 Research Symposium, International Conference on Health Disparities, on September 8, 2023.

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Section: Discussionmentioning

confidence: 99%

Use of Translational Science, Continuous Glucose Monitoring in the Primary Care Setting for Management of Nesidioblastosis: A Case Report and Literature Review

Manandhar,

Farahneh,

Damlakhy

et al. 2024

Cureus

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“…The second-line drugs are somatostatin analogues, including octreotide and lanreotide. Kato et al [ 17 ] reported a case of adult-onset nesidioblastosis which was successfully treated with pancreaticoduodenectomy and octreotide, but their poor affinity to somatostatin receptors resulting in reduced efficiency. Pasireotide is another somatostatin analogue with a higher affinity to somatostatin receptors, and its long-acting release has been proved effective in isolated nesidioblastosis[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Adult focal β-cell nesidioblastosis: A case report

Tu¹,

Zhao²,

Gu³

2023

World J Clin Cases

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BACKGROUND Nesidioblastosis usually refers to a series of clinical manifestations caused by the proliferation of β-cells in pancreatic islets, and these clinical manifestations are hyperinsulinemia and persistent hypoglycemia. According to the size of the lesion, nesidioblastosis is divided into focal nesidioblastosis, diffuse nesidioblastosis and atypical nesidioblastosis, and its pathogenesis is still unclear. Nesidioblastosis is mainly seen in infants and rarely reported in adults, especially focal nesidioblastosis, which is difficult to distinguish from insulinoma. CASE SUMMARY We report a case of adult focal β-cell nesidioblastosis in which the preoperative diagnosis was insulinoma. The patient was a 48-year-old male who suffered from repeated morning and fasting palpitations, sweating, and severe disturbance of consciousness for 5 years. His blood glucose was found to be as low as 1.79 mmol/L during an attack. However, abdominal computed tomography showed no abnormalities. Magnetic resonance imaging and endoscopic ultrasonography demonstrated a nodular mass in the head of the pancreas, combined with hyperinsulinemia and high serum C-peptide. The patient was diagnosed with insulinoma and underwent Beger surgery; however, the postoperative pathological results showed nesidioblastosis. CONCLUSION Although surgical resection is the preferred option for nesidioblastosis, some cases can be treated non-surgically. In order to increase clinicians' understanding of nesidioblastosis, it is necessary to review the pathogenesis, diagnosis and treatment of this disease.

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“…The second-line drugs are somatostatin analogues, including octreotide and lanreotide. Rina Kato et al reported a case of adult-onset nesidioblastosis which was successfully treated with pancreaticoduodenectomy and octreotide [17] , but their poor affinity to somatostatin receptors resulting in reduced efficiency. Pasireotide is another somatostatin analogue with a higher affinity to somatostatin receptors, and its long-acting release has been proved effective in isolated nesidioblastosis [18] .…”

Section: Discussionmentioning

confidence: 99%

Adult focal β-cell nesidioblastosis: A case report and literature review

Zhao

2022

Preprint

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BACKGROUND: Nesidioblastosis usually refers to a series of clinical manifestations caused by the proliferation of β-cells in pancreatic islets, and these clinical manifestations are hyperinsulinemia and persistent hypoglycemia. According to the size of the lesion, nesidioblastosis is divided into focal nesidioblastosis, diffuse nesidioblastosis and atypical nesidioblastosis, and its pathogenesis is still unclear. Nesidioblastosis is mainly seen in infants and rarely reported in adults, especially focal nesidioblastosis, which is difficult to distinguish from insulinoma. CASE SUMMARY: We report a case of adult focal β-cell nesidioblastosis in which the preoperative diagnosis was insulinoma. The patient was a 48-year-old male who suffered from repeated morning and fasting palpitations, sweating, and severe disturbance of consciousness for 5 years. His blood glucose was found to be as low as 1.79 mmol/L during an attack. However, abdominal computed tomography showed no abnormalities. Magnetic resonance imaging and endoscopic ultrasonography demonstrated a nodular mass in the head of the pancreas, combined with hyperinsulinemia and high serum C-peptide. The patient was diagnosed with insulinoma and underwent Beger surgery; however, the postoperative pathological results showed nesidioblastosis. CONCLUSION: Although surgical resection is the preferred option for nesidioblastosis, some cases can be treated non-surgically. In order to increase clinicians' understanding of nesidioblastosis, it is necessary to review the pathogenesis, diagnosis and treatment of this disease.

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Successful treatment of adult‐onset nesidioblastosis by continuous subcutaneous octreotide infusion in a patient on hemodialysis

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 4 publications

References 12 publications

Use of Translational Science, Continuous Glucose Monitoring in the Primary Care Setting for Management of Nesidioblastosis: A Case Report and Literature Review

Use of Translational Science, Continuous Glucose Monitoring in the Primary Care Setting for Management of Nesidioblastosis: A Case Report and Literature Review

Adult focal β-cell nesidioblastosis: A case report

Adult focal β-cell nesidioblastosis: A case report and literature review

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