Insulin gene expression in adult-onset nesidioblastosis

Nesidioblastosis is a well‐recognized cause of persistent hypoglycaemia in neonates. We describe the case of a 24‐year‐old woman who presented with hyperinsulinaemic hypoglycaemia in whom an insulinoma could not be identified at operation which resulted in her undergoing a subtotal distal pancreatec...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 1997-08, Vol.47 (2), p.245-250
Main Authors: Fuller, Peter J., Ehrlich, Allison R., Susil, Beatrice, Zeimer, Howard
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Female
Gene Expression
Glucagon - genetics
Humans
Hypoglycemia - etiology
In Situ Hybridization
Insulin - genetics
Medical sciences
Pancreas - metabolism
Pancreatic Diseases - metabolism
Pancreatic Diseases - surgery
Proglucagon
Protein Precursors - genetics
Tumors. Hypoglycemia
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Summary:Nesidioblastosis is a well‐recognized cause of persistent hypoglycaemia in neonates. We describe the case of a 24‐year‐old woman who presented with hyperinsulinaemic hypoglycaemia in whom an insulinoma could not be identified at operation which resulted in her undergoing a subtotal distal pancreatectomy. Histological examination revealed the presence of nesidioblastosis. The finding of nesidioblastosis in adults has been reported previously, albeit rarely. We report the use of in situ hybridization to characterize the patterns of insulin and proglucagon gene expression in the resected pancreas. Insulin expression was observed in both the islets and also the isolated nesidioblasts. The α‐cells of the islets had lost their usual peripheral distribution suggesting that not only is insulin gene expression dysregulated but that the islets are structurally abnormal.
ISSN:0300-0664
1365-2265
DOI:10.1046/j.1365-2265.1997.2371046.x