Spontaneous Hypoglycemia in a Non-diabetic Patient: A Diagnostic and Therapeutic Conundrum

TL;DR

A non-diabetic man with long-term hypoglycemia symptoms was diagnosed with nesidioblastosis, a rare condition often mistaken for insulinoma.

Contribution

This case highlights the diagnostic challenges of nesidioblastosis and its distinction from insulinoma.

Findings

The patient exhibited hypoglycemia symptoms for two years without diabetes or insulinoma.

Nesidioblastosis was diagnosed after ruling out other common causes of hypoglycemia.

The case underscores the importance of considering rare endogenous causes in hypoglycemia evaluation.

Abstract

Hypoglycaemia is a medical emergency requiring an immediate intervention to prevent neuroglycopenic symptoms such as confusion, seizures, and coma. While evaluating for the cause of hypoglycemia, after excluding common causes like insulin use or sepsis, other causes involving endogenous hypoglycemia need to be evaluated. A cause to be considered is nesidioblastosis. This rare entity is also known as non-insulinoma pancreatogenous hypoglycemia syndrome. There have been instances where this disorder has been mistaken as insulinoma due to the characteristics shared by the two. Here, we present a case of a non-diabetic male experiencing symptoms of giddiness and palpitations for the past two years who had been extensively evaluated to rule out insulinoma and was diagnosed with nesidioblastosis.

Figures