Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history
Nesidioblastosis is a rare condition of organic persistent hyperinsulinaemic hypoglycaemia, with fewer than 100 cases since it was first recorded. However, an increasing prevalence suggests previous underdiagnosis due to poor knowledge and awareness. This case describes the presentation, clinical de...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-11-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472423005069/type/journal_article |
| _version_ | 1797655961820725248 |
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| author | Lee Ann Santore Soumya Mandava Gloria Lee Mason Chacko |
| author_facet | Lee Ann Santore Soumya Mandava Gloria Lee Mason Chacko |
| author_sort | Lee Ann Santore |
| collection | DOAJ |
| description | Nesidioblastosis is a rare condition of organic persistent hyperinsulinaemic hypoglycaemia, with fewer than 100 cases since it was first recorded. However, an increasing prevalence suggests previous underdiagnosis due to poor knowledge and awareness. This case describes the presentation, clinical decision-making and unique challenges in diagnosis and care of a 21-year-old female with nesidioblastosis and extensive psychiatric comorbidities. She was repeatedly misdiagnosed until 2021, despite having presented to emergency departments with hypoglycaemic symptoms for over 7 years. Her symptoms were often misattributed to behaviours secondary to restrictive anorexia nervosa and borderline personality disorder. Even after appropriate diagnosis and management, she suffered a complicated post-operative course. Patients with psychiatric comorbidities are at higher risk of distress, communication difficulties and inadequate social support, all of which could be better managed with increased multidisciplinary collaboration between endocrine, surgery, psychiatry, pain management and social work. This study highlights the importance of well-rounded patient care that addresses all facets of patient health. This approach not only improves quality of care, but also reduces overall readmissions, revisions, morbidity and mortality. |
| first_indexed | 2024-03-11T17:22:18Z |
| format | Article |
| id | doaj.art-19a0d3ae6b4d47f0b6a4fb2afc7c1b65 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-03-11T17:22:18Z |
| publishDate | 2023-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-19a0d3ae6b4d47f0b6a4fb2afc7c1b652023-10-19T08:47:02ZengCambridge University PressBJPsych Open2056-47242023-11-01910.1192/bjo.2023.506Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric historyLee Ann Santore0Soumya Mandava1https://orcid.org/0000-0002-3522-1191Gloria Lee2Mason Chacko3Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New York, USARenaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New York, USADepartment of Psychiatry and Behavioral Health, Stony Brook University Hospital, Stony Brook, New York, USADepartment of Psychiatry and Behavioral Health, Stony Brook University Hospital, Stony Brook, New York, USANesidioblastosis is a rare condition of organic persistent hyperinsulinaemic hypoglycaemia, with fewer than 100 cases since it was first recorded. However, an increasing prevalence suggests previous underdiagnosis due to poor knowledge and awareness. This case describes the presentation, clinical decision-making and unique challenges in diagnosis and care of a 21-year-old female with nesidioblastosis and extensive psychiatric comorbidities. She was repeatedly misdiagnosed until 2021, despite having presented to emergency departments with hypoglycaemic symptoms for over 7 years. Her symptoms were often misattributed to behaviours secondary to restrictive anorexia nervosa and borderline personality disorder. Even after appropriate diagnosis and management, she suffered a complicated post-operative course. Patients with psychiatric comorbidities are at higher risk of distress, communication difficulties and inadequate social support, all of which could be better managed with increased multidisciplinary collaboration between endocrine, surgery, psychiatry, pain management and social work. This study highlights the importance of well-rounded patient care that addresses all facets of patient health. This approach not only improves quality of care, but also reduces overall readmissions, revisions, morbidity and mortality.https://www.cambridge.org/core/product/identifier/S2056472423005069/type/journal_articleComorbidityhistory of psychiatrystigma and discriminationborderline personality disorderanorexia nervosa |
| spellingShingle | Lee Ann Santore Soumya Mandava Gloria Lee Mason Chacko Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history BJPsych Open Comorbidity history of psychiatry stigma and discrimination borderline personality disorder anorexia nervosa |
| title | Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history |
| title_full | Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history |
| title_fullStr | Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history |
| title_full_unstemmed | Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history |
| title_short | Nesidioblastosis with delayed diagnosis and post-operative complications in a patient with complex psychiatric history |
| title_sort | nesidioblastosis with delayed diagnosis and post operative complications in a patient with complex psychiatric history |
| topic | Comorbidity history of psychiatry stigma and discrimination borderline personality disorder anorexia nervosa |
| url | https://www.cambridge.org/core/product/identifier/S2056472423005069/type/journal_article |
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