A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome

As the obesity pandemic continues to worsen and medical interventions remain only moderately effective, bariatric surgery remains an important option for patients. In certain instances, patients who have undergone the procedure experience postprandial symptoms of neuroglycopenia caused by noninsulin...

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Main Authors: Jeffrey Nadelson, Alan Epstein
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2012/164305
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author Jeffrey Nadelson
Alan Epstein
author_facet Jeffrey Nadelson
Alan Epstein
author_sort Jeffrey Nadelson
collection DOAJ
description As the obesity pandemic continues to worsen and medical interventions remain only moderately effective, bariatric surgery remains an important option for patients. In certain instances, patients who have undergone the procedure experience postprandial symptoms of neuroglycopenia caused by noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS). NIPHS is a recently described syndrome and is also very rare, and therapeutic approaches are still under debate. We report the case of a 51-year-old female who underwent Roux-en-Y gastric bypass and presented with episodic postprandial hypoglycemia 2 years after surgery. An insulinoma was absent from all abdominal imaging. Fasting C-peptide, insulin, and glucose were normal. Due to the possibility of NIPHS, clinical treatment was commenced with acarbose, leading to a significant reduction of hypoglycemic episodes. NIPHS occurs in approximately 0.5% to 7% of patients with hyperinsulinemic hypoglycemia. Sporadic hypoglycemia postgastric bypass is an important entity that should be understood by all surgeons and internists who are involved in postgastric bypass care.
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spelling doaj-art-8bc101100d4e443cb16efbb54060de582025-08-20T02:09:14ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362012-01-01201210.1155/2012/164305164305A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia SyndromeJeffrey Nadelson0Alan Epstein1Section of Gastroenterology, Department of Medicine, Roger Williams Medical Center, Boston University School of Medicine, 825 Chalkstone Avenue, Providence, RI 02908, USASection of Gastroenterology, Department of Medicine, Roger Williams Medical Center, Boston University School of Medicine, 825 Chalkstone Avenue, Providence, RI 02908, USAAs the obesity pandemic continues to worsen and medical interventions remain only moderately effective, bariatric surgery remains an important option for patients. In certain instances, patients who have undergone the procedure experience postprandial symptoms of neuroglycopenia caused by noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS). NIPHS is a recently described syndrome and is also very rare, and therapeutic approaches are still under debate. We report the case of a 51-year-old female who underwent Roux-en-Y gastric bypass and presented with episodic postprandial hypoglycemia 2 years after surgery. An insulinoma was absent from all abdominal imaging. Fasting C-peptide, insulin, and glucose were normal. Due to the possibility of NIPHS, clinical treatment was commenced with acarbose, leading to a significant reduction of hypoglycemic episodes. NIPHS occurs in approximately 0.5% to 7% of patients with hyperinsulinemic hypoglycemia. Sporadic hypoglycemia postgastric bypass is an important entity that should be understood by all surgeons and internists who are involved in postgastric bypass care.http://dx.doi.org/10.1155/2012/164305
spellingShingle Jeffrey Nadelson
Alan Epstein
A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
Case Reports in Gastrointestinal Medicine
title A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
title_full A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
title_fullStr A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
title_full_unstemmed A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
title_short A Rare Case of Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
title_sort rare case of noninsulinoma pancreatogenous hypoglycemia syndrome
url http://dx.doi.org/10.1155/2012/164305
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