Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea
BackgroundEndogenous hyperinsulinemic hypoglycemia (EHH) is characterized by an inappropriately high plasma insulin level, despite a low plasma glucose level. Most of the EHH cases are caused by insulinoma, whereas nesidioblastosis and insulin autoimmune syndrome (IAS) are relatively rare.MethodsTo...
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2015-04-01
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| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-126.pdf |
| _version_ | 1811240193479409664 |
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| author | Chang-Yun Woo Ji Yun Jeong Jung Eun Jang Jaechan Leem Chang Hee Jung Eun Hee Koh Woo Je Lee Min-Seon Kim Joong-Yeol Park Jung Bok Lee Ki-Up Lee |
| author_facet | Chang-Yun Woo Ji Yun Jeong Jung Eun Jang Jaechan Leem Chang Hee Jung Eun Hee Koh Woo Je Lee Min-Seon Kim Joong-Yeol Park Jung Bok Lee Ki-Up Lee |
| author_sort | Chang-Yun Woo |
| collection | DOAJ |
| description | BackgroundEndogenous hyperinsulinemic hypoglycemia (EHH) is characterized by an inappropriately high plasma insulin level, despite a low plasma glucose level. Most of the EHH cases are caused by insulinoma, whereas nesidioblastosis and insulin autoimmune syndrome (IAS) are relatively rare.MethodsTo evaluate the relative frequencies of various causes of EHH in Korea, we retrospectively analyzed 84 patients who were diagnosed with EHH from 1998 to 2012 in a university hospital.ResultsAmong the 84 EHH patients, 74 patients (88%), five (6%), and five (6%) were diagnosed with insulinoma, nesidioblastosis or IAS, respectively. The most common clinical manifestation of EHH was neuroglycopenic symptoms. Symptom duration before diagnosis was 14.5 months (range, 1 to 120 months) for insulinoma, 1.0 months (range, 6 days to 7 months) for nesidioblastosis, and 2.0 months (range, 1 to 12 months) for IAS. One patient, who was diagnosed with nesidioblastosis in 2006, underwent distal pancreatectomy but was later determined to be positive for insulin autoantibodies. Except for one patient who was diagnosed in 2007, the remaining three patients with nesidioblastosis demonstrated severe hyperinsulinemia (157 to 2,719 µIU/mL), which suggests that these patients might have had IAS, rather than nesidioblastosis.ConclusionThe results of this study suggest that the prevalence of IAS may be higher in Korea than previously thought. Therefore, measurement of insulin autoantibody levels is warranted for EHH patients, especially in patients with very high plasma insulin levels. |
| first_indexed | 2024-04-12T13:14:47Z |
| format | Article |
| id | doaj.art-000dc8c337ad45cdb124371b847413f6 |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-04-12T13:14:47Z |
| publishDate | 2015-04-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-000dc8c337ad45cdb124371b847413f62022-12-22T03:31:43ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872015-04-0139212613110.4093/dmj.2015.39.2.12614666Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in KoreaChang-Yun WooJi Yun JeongJung Eun JangJaechan LeemChang Hee JungEun Hee KohWoo Je LeeMin-Seon KimJoong-Yeol ParkJung Bok LeeKi-Up LeeBackgroundEndogenous hyperinsulinemic hypoglycemia (EHH) is characterized by an inappropriately high plasma insulin level, despite a low plasma glucose level. Most of the EHH cases are caused by insulinoma, whereas nesidioblastosis and insulin autoimmune syndrome (IAS) are relatively rare.MethodsTo evaluate the relative frequencies of various causes of EHH in Korea, we retrospectively analyzed 84 patients who were diagnosed with EHH from 1998 to 2012 in a university hospital.ResultsAmong the 84 EHH patients, 74 patients (88%), five (6%), and five (6%) were diagnosed with insulinoma, nesidioblastosis or IAS, respectively. The most common clinical manifestation of EHH was neuroglycopenic symptoms. Symptom duration before diagnosis was 14.5 months (range, 1 to 120 months) for insulinoma, 1.0 months (range, 6 days to 7 months) for nesidioblastosis, and 2.0 months (range, 1 to 12 months) for IAS. One patient, who was diagnosed with nesidioblastosis in 2006, underwent distal pancreatectomy but was later determined to be positive for insulin autoantibodies. Except for one patient who was diagnosed in 2007, the remaining three patients with nesidioblastosis demonstrated severe hyperinsulinemia (157 to 2,719 µIU/mL), which suggests that these patients might have had IAS, rather than nesidioblastosis.ConclusionThe results of this study suggest that the prevalence of IAS may be higher in Korea than previously thought. Therefore, measurement of insulin autoantibody levels is warranted for EHH patients, especially in patients with very high plasma insulin levels.http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-126.pdfAutoimmune diseasesHyperinsulinismHypoglycemiaInsulin antibodiesInsulinomaNesidioblastosis |
| spellingShingle | Chang-Yun Woo Ji Yun Jeong Jung Eun Jang Jaechan Leem Chang Hee Jung Eun Hee Koh Woo Je Lee Min-Seon Kim Joong-Yeol Park Jung Bok Lee Ki-Up Lee Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea Diabetes & Metabolism Journal Autoimmune diseases Hyperinsulinism Hypoglycemia Insulin antibodies Insulinoma Nesidioblastosis |
| title | Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea |
| title_full | Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea |
| title_fullStr | Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea |
| title_full_unstemmed | Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea |
| title_short | Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea |
| title_sort | clinical features and causes of endogenous hyperinsulinemic hypoglycemia in korea |
| topic | Autoimmune diseases Hyperinsulinism Hypoglycemia Insulin antibodies Insulinoma Nesidioblastosis |
| url | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-126.pdf |
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