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A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status.
J Pediatr Endocrinol Metab. 2014 Jul; 27(7-8):773-6.JP

Abstract

BACKGROUND

Multiple endocrine neoplasia type 1 (MEN1) is an inherited neoplasia syndrome that generally presents with hypercalcaemia due to hyperparathyroidism. Insulin-producing tumours are less common components of the syndrome that emerge later during the course of the disease. We report here a case of an adolescent who presented with symptomatic hypoglycaemia as the first indication of MEN1.

CASE

A 14-year-old boy, known to use illicit drugs, was brought to the hospital with altered mental status. He was hypoglycaemic and further investigations revealed two pancreatic insulinomas. Despite having no relevant family history, genetic evaluation showed a mutation consistent with MEN1.

CONCLUSION

Insulinomas in adolescents are generally rare and even less common as a first presentation of MEN1. This diagnosis carries implications for potential future neoplasms, both benign and malignant. While intoxication is a more common case of altered mental status in adolescents, clinicians must maintain a high index of suspicion for organic disease.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24756045

Citation

Winston, Karin Y., and Jonathan Dawrant. "A Rare Case of Hypoglycaemia Due to Insulinoma in an Adolescent With Acutely Altered Mental Status." Journal of Pediatric Endocrinology & Metabolism : JPEM, vol. 27, no. 7-8, 2014, pp. 773-6.
Winston KY, Dawrant J. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status. J Pediatr Endocrinol Metab. 2014;27(7-8):773-6.
Winston, K. Y., & Dawrant, J. (2014). A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status. Journal of Pediatric Endocrinology & Metabolism : JPEM, 27(7-8), 773-6. https://doi.org/10.1515/jpem-2013-0353
Winston KY, Dawrant J. A Rare Case of Hypoglycaemia Due to Insulinoma in an Adolescent With Acutely Altered Mental Status. J Pediatr Endocrinol Metab. 2014;27(7-8):773-6. PubMed PMID: 24756045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status. AU - Winston,Karin Y, AU - Dawrant,Jonathan, PY - 2013/08/30/received PY - 2014/02/28/accepted PY - 2014/4/24/entrez PY - 2014/4/24/pubmed PY - 2015/3/3/medline SP - 773 EP - 6 JF - Journal of pediatric endocrinology & metabolism : JPEM JO - J Pediatr Endocrinol Metab VL - 27 IS - 7-8 N2 - BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is an inherited neoplasia syndrome that generally presents with hypercalcaemia due to hyperparathyroidism. Insulin-producing tumours are less common components of the syndrome that emerge later during the course of the disease. We report here a case of an adolescent who presented with symptomatic hypoglycaemia as the first indication of MEN1. CASE: A 14-year-old boy, known to use illicit drugs, was brought to the hospital with altered mental status. He was hypoglycaemic and further investigations revealed two pancreatic insulinomas. Despite having no relevant family history, genetic evaluation showed a mutation consistent with MEN1. CONCLUSION: Insulinomas in adolescents are generally rare and even less common as a first presentation of MEN1. This diagnosis carries implications for potential future neoplasms, both benign and malignant. While intoxication is a more common case of altered mental status in adolescents, clinicians must maintain a high index of suspicion for organic disease. SN - 2191-0251 UR - https://www.unboundmedicine.com/medline/citation/24756045/A_rare_case_of_hypoglycaemia_due_to_insulinoma_in_an_adolescent_with_acutely_altered_mental_status_ L2 - https://www.degruyter.com/document/doi/10.1515/jpem-2013-0353 DB - PRIME DP - Unbound Medicine ER -