An Insulinoma for which Secretin Test and Selective Arterial Calcium Injection Test were Useful
スポンサーリンク
概要
- 論文の詳細を見る
A 76-year-old woman suffered from somnolence while fasting for almost 2 years. Fasting plasma glucose (FPG) (40 mg/dl) and the immunoreactive insulin (IRI) level (8.8 μU/ml) were not compatible with Fajans ratio or Turners ratio observed in typical insulinoma. The secretin test showed no response to insulin secretion, suggesting the presence of insulinoma. Abdominal dynamic computed tomography (CT) revealed a 12-mm hypervascular lesion in the head of the pancreas. A selective arterial calcium infusion test (SACI) was performed, during which IRI in the hepatic venous blood was measured following selective intraarterial calcium infusion. An increase in IRI levels in the gastroduodenal and superior mesenteric arteries suggested the presence of a functional insulinoma in the head of the pancreas. Enucleation of the tumor improved FPG and IRI levels to 138 mg/dl and 3.8 μU/ml, respectively. After surgery, a secretin test showed a 5-fold increase in IRI levels, suggesting normal β cell function. This case illustrates the value of the secretin test for the diagnosis of insulinoma and for the postoperative assessment of β cell function. It further illustrates the value of the SACI for localizing an insulinoma.(Internal Medicine 41: 839-841, 2002)
著者
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TANAKA Nagaaki
Department of Metabolism and Endocrinology
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YAMAMOTO Tsunehiko
Department of Metabolism and Endocrinology
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TOYOKAWA Akihiro
Department of Internal Medicine, Osaka City Kita Hospital
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Manabe Takao
Radiology Osaka City General Hospital
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Ishii Tomofusa
Department Of Internal Medicine Osaka City General Hospital
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Hosoi Masayuki
Department Of Endocrinology And Metabolism Osaka City General Hospital
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Toyokawa Akihiro
Department Of Internal Medicine Osaka City Kita Hospital
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Yoshioka Katsunobu
Department Of Endocrinology And Metabolism Osaka City General Hospital
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Sato Toshihiko
Department Of Cardiology Tokyo Women's Medical University
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Yamazaki Osamu
Department Of Chemistry Faculty Of Science Chiba University
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Tanaka Shiro
Department Of Clinical Trial Design And Management Translational Research Center Kyoto University Hospital
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YAMAZAKI Osamu
Department of Gastrointestinal Surgery, Osaka City Kita Hospital
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Fum Satoru
Department of Metabolism and Endocrinology, Osaka City Kita Hospital
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Hosoi Masayuki
Department of Metabolism and Endocrinology, Osaka City Kita Hospital
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Hosoi Masayuki
Department of Diabetes and Endocrinology, Osaka City General Hospital, Japan
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YAMAMOTO Tsunehiko
Department of Metabolism and Endocrinology, Osaka City Kita Hospital
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TANAKA Shiro
Department of Metabolism and Endocrinology, Osaka City Kita Hospital
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