Hyperinsulinemic hypoglycemia with nesidioblastosis: Histologic features and growth factor expression

Kandelaria M. Rumilla, Lori A. Erickson, F. John Service, Adrian Vella, Geoffrey B. Thompson, Clive S. Grant, Ricardo V. Lloyd

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

Hypoglycemia secondary to nesidioblastosis is rare in adults, and the pathogenesis of this condition is unknown. To determine factors leading to nesidioblastosis in adults, we analyzed 36 cases of nesidioblastosis including 27 cases of postgastric bypass nesidioblastosis and 9 cases of idiopathic nesidioblastosis in adults by immunohistochemistry using antibodies to insulin-like growth factor1, insulin-like growth factor2 (IGF2), insulin-like growth factor one receptor-α epidermal growth factor receptor, transforming growth factor-β1 and 2, and transforming growth factor-β receptor type 3. Fifty-two surgically excised pancreatic specimens from patients with benign exocrine tumors and no evidence of hypoglycemia were used as controls. There was increased IGF2, insulin-like growth factor receptor1 receptor-α and transforming growth factor-β receptor 3 expression in islets from nesidioblastosis patients compared to controls. Peliosis-type vascular ectasia was more common in nesidioblastosis patients compared to controls. These findings suggest that increased production of growth factors and growth factor receptors may contribute to the development of nesidioblastosis in adults.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalModern Pathology
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Gastric bypass
  • IGF1Rα
  • IGF2
  • Nesidioblastosis
  • Peliosis
  • TGFβR3

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Rumilla, K. M., Erickson, L. A., Service, F. J., Vella, A., Thompson, G. B., Grant, C. S., & Lloyd, R. V. (2009). Hyperinsulinemic hypoglycemia with nesidioblastosis: Histologic features and growth factor expression. Modern Pathology, 22(2), 239-245. https://doi.org/10.1038/modpathol.2008.169