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MAJ William J. Burman, MC; LTC Michael T. McDermott, MC; COL Michael Bornemann, MC

Arch Intern Med. 1992;152(10):2125-2127.

Abstract
Two adult siblings presented with recurrent syncope due to severe hyperinsulinemic hypoglycemia. Exploratory laparotomy in the elder sibling showed a grossly normal pancreas, but histologic examination revealed islet cell hyperplasia. Neither sibling has any evidence of the multiple endocrine neoplasia type 1 syndrome, nor is there any other family history to suggest this diagnosis. To our knowledge, this is the first report of adult-onset familial hyperinsulinism without other manifestations of multiple endocrine neoplasia type 1 syndrome. A simple provocative test for hyperinsulinism was also suggested by these cases. Because the initial patient related his symptoms to exercise, we used treadmill exercise in both patients to diagnose hyperinsulinism and observe its response to therapy.

(Arch Intern Med. 1992;152:2125-2127)

Author Affiliations
USA; USA; USA

From the Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colo. Dr Bornemann is now with the Department of Medicine, Tripler Army Medical Center (Hawaii).

Footnotes
Accepted for publication May 11, 1992.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Department of Medicine, Tripler Army Medical Center, Tripler Army Medical Center, HI 96859-5000 (Dr Bornemann).

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