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Hyperinsulinism: Three Cases Relieved by Radiation

Hyperinsulinism: Three Cases Relieved by Radiation Hyperinsulinism: Three Cases Relieved by Radiation 1 S. C. Barrow , M.D. Shreveport, La. ↵ 1 Presented before the Radiological Society of North America, at the Twentieth Annual Meeting, in Memphis, Tenn., Dec. 3–7, 1934. Excerpt THE disease entity hyperinsulinism, accompanied and characterized by certain symptoms, the result of hypoglycemia, was first brought to the attention of the profession by Harris (1), in 1924. Shortly after the discovery of insulin by Banting in 1922, reports of cases receiving overdoses began to appear. The symptomatology noted in these cases resembled so closely symptom-complexes frequently observed in certain patients in whom pancreatic disease had not been suspected and in whom insulin had not been given, that a relationship as to cause was the logical conclusion in Harris' mind. In his first communication, he reported two cases—non-diabetic patients who had not received insulin—in which the symptoms observed were identical with certain other cases which were known to have received an over-dose of insulin. Both of these cases had low blood sugar, and in each the symptoms were controlled by carbohydrate diet. If a certain group of cases, receiving an over-dose of insulin, showed the same symptom-complex as another group that had not received insulin, Harris reasoned that there must be existing in this latter group, spontaneously, an excess of insulin. Hence the term hyperinsulinism, an over-secretion of the islets of Langerhans which Harris considers a disease analogous to hyperthyroidism, hyperpituitarism, hyperadren-alism, etc. Incidentally he argues that “hypoinsulinism” would be a preferable term to describe diabetes or hyperglycemia. The symptoms of hyperinsulinism, while protean, are generally familiar to the profession to-day; the procedures in arriving at a diagnosis and the methods of treatment are somewhat standardized, but the etiology in many cases remains unsettled and unexplained. Hyperinsulinism is a disease of the pancreas, although hypoglycemia, its distinctive and constantly accompanying condition, may be due to disease of other organs or secreting glands. The first case of unconsciousness and convulsions, proven to be due to hyperinsulinism, was reported by Allen (2) in 1928. Autopsy in this case showed carcinoma of the pancreas with metastasis to the liver, the metastatic areas in the liver showing islet cells with insulin production. Allen (3), in 1928, reported two other cases of hyperinsulinism with recurring attacks of convulsions. In 1929, Howland (4) reported the first case of hyperinsulinism, showing convulsions and coma, which was cured by surgical removal of an adenoma of the pancreas. In 1931, Car (5) reported a case, a boy 18 years of age, diagnosed as adenoma of the pancreas, who was cured by operative removal of the adenoma. This patient was having convulsions and marked hypoglycemia. In 1932, Womack, Grogi, and Graham (6) reported the removal from the pancreas of a small adenoma, with cure of hypoglycemia and relief of mental confusions and unconsciousness. copyrighted by the Radiological Society of North America, Inc. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

Hyperinsulinism: Three Cases Relieved by Radiation

Barrow, S. C.
Radiology , Volume 24 (3): 320 – Mar 1, 1935
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Publisher
Radiological Society of North America, Inc.
Copyright
Copyright © 1935 by Radiological Society of North America
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/24.3.320
Publisher site
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Abstract

Hyperinsulinism: Three Cases Relieved by Radiation 1 S. C. Barrow , M.D. Shreveport, La. ↵ 1 Presented before the Radiological Society of North America, at the Twentieth Annual Meeting, in Memphis, Tenn., Dec. 3–7, 1934. Excerpt THE disease entity hyperinsulinism, accompanied and characterized by certain symptoms, the result of hypoglycemia, was first brought to the attention of the profession by Harris (1), in 1924. Shortly after the discovery of insulin by Banting in 1922, reports of cases receiving overdoses began to appear. The symptomatology noted in these cases resembled so closely symptom-complexes frequently observed in certain patients in whom pancreatic disease had not been suspected and in whom insulin had not been given, that a relationship as to cause was the logical conclusion in Harris' mind. In his first communication, he reported two cases—non-diabetic patients who had not received insulin—in which the symptoms observed were identical with certain other cases which were known to have received an over-dose of insulin. Both of these cases had low blood sugar, and in each the symptoms were controlled by carbohydrate diet. If a certain group of cases, receiving an over-dose of insulin, showed the same symptom-complex as another group that had not received insulin, Harris reasoned that there must be existing in this latter group, spontaneously, an excess of insulin. Hence the term hyperinsulinism, an over-secretion of the islets of Langerhans which Harris considers a disease analogous to hyperthyroidism, hyperpituitarism, hyperadren-alism, etc. Incidentally he argues that “hypoinsulinism” would be a preferable term to describe diabetes or hyperglycemia. The symptoms of hyperinsulinism, while protean, are generally familiar to the profession to-day; the procedures in arriving at a diagnosis and the methods of treatment are somewhat standardized, but the etiology in many cases remains unsettled and unexplained. Hyperinsulinism is a disease of the pancreas, although hypoglycemia, its distinctive and constantly accompanying condition, may be due to disease of other organs or secreting glands. The first case of unconsciousness and convulsions, proven to be due to hyperinsulinism, was reported by Allen (2) in 1928. Autopsy in this case showed carcinoma of the pancreas with metastasis to the liver, the metastatic areas in the liver showing islet cells with insulin production. Allen (3), in 1928, reported two other cases of hyperinsulinism with recurring attacks of convulsions. In 1929, Howland (4) reported the first case of hyperinsulinism, showing convulsions and coma, which was cured by surgical removal of an adenoma of the pancreas. In 1931, Car (5) reported a case, a boy 18 years of age, diagnosed as adenoma of the pancreas, who was cured by operative removal of the adenoma. This patient was having convulsions and marked hypoglycemia. In 1932, Womack, Grogi, and Graham (6) reported the removal from the pancreas of a small adenoma, with cure of hypoglycemia and relief of mental confusions and unconsciousness. copyrighted by the Radiological Society of North America, Inc.

Journal

Radiology – Radiological Society of North America, Inc.

Published: Mar 1, 1935

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