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Diphenylhydantoin and an Insulin-Secreting Islet Adenoma
Robert H. Knopp, MD;
James C. Sheinin, MD;
Norbert Freinkel, MD
Arch Intern Med. 1972;130(6):904-908.
Abstract
The diagnosis of an insulin-secreting islet cell adenoma was obscured in a patient treated with diphenylhydantoin sodium. Comparison of insulin responses to glucagon, tolbutamide, and leucine before and after drug withdrawal indicated that the diphenylhydantoin was inhibiting "stimulated" insulin release from the tumor. Another clue to hyperinsulinism was the restraint of hepatic ketogenesis and urinary nitrogen excretion during fasting. Diphenylhydantoin, or an analogue, may deserve further trial as adjunctive therapy in the control of insulinoma-induced hypoglycemia.
Author Affiliations
Chicago
From the Section of Endocrinology and Metabolism, Department of Medicine, Northwestern University-McGaw Medical Center, Chicago. Dr. Knopp is now with the Thorndike Memorial Laboratory, Boston City Hospital, Boston.
Footnotes
Submitted for publication April 26, 1972; accepted May 1.
Reprint requests to 303 E Chicago Ave, Chicago 60611 (Dr. Freinkel).
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