Pancreatic tissue from a case of neonatal hypoglycaemia with nesidioblastosis has been studied by routine light and electron microscope techniques and by highly sensitive light and electron microscope immunolocalization methods. A hyperplastic nodule within the pancreas from this case contained enlarged distorted haemorrhagic islets, with a variable rim of exocrine tissue. Islet cells in these areas were shown to contain more than one hormone in separate granules. An immunoperoxidase system using hapten-labelled primary antibodies and photochemical amplification applied to serial semithin sections suggested a consistent overlap between insulin and glucagon immunoreactive cells. Serial ultrathin sections of tissue embedded in LR White showed that some heteromorphous cells with predominantly beta-granules also contained a minority population of granules which had either glucagon or glicentin immunoreactivity. In adjacent studies, the same techniques confirmed that the majority population of granules did indeed contain insulin, and immunocolloidal gold methods were used to show that glucagon and glicentin containing granules were present in the same cells. The significance of these findings is discussed, including the possibility that cells containing more than one granule type might represent a subpopulation of facultative cells in transit from producing one hormone to producing a second. The importance of sensitive immuno-electron microscopy in the investigation of endocrine lesions is stressed.
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JCEM Case Rep
January 2025
Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433.
A 75-year-old female presented with fasting hypoglycemic episodes. A supervised fast ended at 72 hours fulfilling Whipple triad, with suppressed insulin and C-peptide levels, but discordantly suppressed serum β-hydroxybutyrate levels. After 21 months of recurring symptoms, a repeat fast ended at 48 hours with Whipple triad, suppressed serum β-hydroxybutyrate level, and borderline nonsuppressed C-peptide level, suggesting endogenous hyperinsulinism.
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Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco.
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View Article and Find Full Text PDFJ Family Med Prim Care
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Department of Surgery, Datta Meghe Medical College, DMIHER University, Wardha, Maharashtra, India.
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Hematology Oncology Associates of CNY, Syracuse, USA.
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Cirugía General y del Aparato Digestivo, Hospital Universitario 12 de Octubre.
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