高度肥満を呈し, 脳萎縮を認めた罹病期間11年のインスリノーマの一例

熊谷 尚子; 相良 光; 林田 佳子; 林 秀樹; 内山 伸二; 栗並 茂; 梶原 敬三; 野中 共平; 宮原 靖; 今任 信彦; 自見 厚郎; 栗原 宏子; 船越 顕博

doi:10.11213/tonyobyo1958.32.541

A Case with an 11-year History of Insulinoma, Marked Obesity, and Cerebral Atrophy

Naoko Kumagai, Hikaru Sagara, Yoshiko Hayashida, Hideki Hayashi, Shinji Uchiyama, Shigeru Kurinami, Keizo Kajiwara, Kyohei Nonaka, Yasushi Miyahara, Nobuhiko Imato, Atsuo Jimi, Hiroko Kurihara(Fujino), Akihiro Funakoshi

Author information

Naoko Kumagai
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Hikaru Sagara
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Yoshiko Hayashida
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Hideki Hayashi
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Shinji Uchiyama
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Shigeru Kurinami
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Keizo Kajiwara
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Kyohei Nonaka
Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
Yasushi Miyahara
Department of Neuropsychiatry, Kurume University School of Medicine
Nobuhiko Imato
Department of Neuropsychiatry, Kurume University School of Medicine
Atsuo Jimi
The First Division, Department of Pathology, Kurume University School of Medicine
Hiroko Kurihara(Fujino)
The Second Department of Internal Medicine, Osaka University Medical School
Akihiro Funakoshi
The Third Division, Department of Internal Medicine, Kyushu University

JOURNAL FREE ACCESS

1989 Volume 32 Issue 7 Pages 541-546

DOI https://doi.org/10.11213/tonyobyo1958.32.541

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Abstract

A 43-year-old female was admitted to this Department of Medicine in 1985 with suspected insulinoma. In 1974, at the age of 31 years, she had experienced an episode of unconsciousness during the third month of pregnancy, and laboratory data at that time suggested a diagnosis of insulinoma. Selective angiography however, demonstrated no mass lesion. This patient had been hospitalized with dementia, by the Department of Neuropsychiatry and the repeated consumption of carbohydrates to prevent hypoglycemic attacks, had resulted in marked obesity, (+83% by Jones' method). In 1985, a series of laboratory tests, including repeatedly determined plasma glucose and insulin levels, glucagon testing, fasting tests, selective angiography, abdominal ultrasonography, and percutaneous transhepatic portal vein catheterization, suggested the presence of a functioning insulinoma in the body of the pancreas. Subsequently, a globular tumor of 12mm in diameter was removed successfully, and this resulted in an almost perfect correction of obesity in approximately 6 months. Computerized tomography (CT) of the patient's brain revealed considerable atrophy mainly in the cerebral cortex ; finding which has been rarely documented in the literature.

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