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Previous Volume 353:249-254 July 21, 2005 Number 3 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Cummings, D. E. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

We describe six patients (five women and one man; median age, 47 years; range, 39 to 54) with postprandial symptoms of neuroglycopenia owing to endogenous hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass surgery. Except for equivocal evidence in one patient, there was no radiologic evidence of insulinoma. Selective arterial calcium-stimulation tests, positive in each patient, were used to guide partial pancreatectomy. Nesidioblastosis was identified in resected specimens from each patient, and multiple insulinomas were identified in one. Hypoglycemic symptoms diminished postoperatively. We speculate that hyperfunction of pancreatic islets did not lead to obesity but that beta-cell trophic factors may have increased as a result of gastric bypass.

Source Information

From the Departments of Surgery (G.J.S., G.B.T.), Radiology (J.C.A.), and Pathology (R.V.L.) and the Division of Endocrinology, Metabolism, and Nutrition (F.J.S., M.L.C.-C.), Mayo Clinic and Foundation, Rochester, Minn.

Address reprint requests to Dr. F. John Service at the Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or at service.john{at}mayo.edu.

Full Text of this Article

Related Letters:

Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass Surgery
Carpenter T., Trautmann M. E., Baron A. D., Kaiser A. M., Service F. J., Thompson G. B., Lloyd R. V., Cummings D. E., Shannon M. H., Carlson M. J.
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N Engl J Med 2005; 353:2192-2194, Nov 17, 2005. Correspondence

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