Ingrid Dravecká, Ivica Lazúrová
Insulinoma is the most common cause of fasting hypoglycemia in non-diabetics related to endogenous hyperinsulinemia.
Its clinical manifestation includes autonomic and neuroglycopenic symptoms of hypoglycemia. Diagnosis is based
on laboratory confirmation of endogenous hyperinsulinemic hypoglycemia during clinical patient’s difficulties or
on the basis of a 72-hour fasting test. Non-invasive imaging procedures, such as ultrasonography, computed tomography,
magnetic resonance imaging, octreoscan and invasive modalities, such as angiography and endoscopic ultrasonography
are used when a laboratory diagnosis of insulinoma has been confirmed. Most patients are treated surgically
(enucleation of cancer eventually partial resection of the pancreas). In the differential diagnosis of hyperinsulinemic
hypoglycemia noninsulinoma pancreatogenous hypoglycemic syndrome causes postprandial hypoglycemia. It is presented
as persistent hyperinsulinemic hypoglycemia in infancy – congenital hyperinsulinism or as adult-onset nesidioblastosis
with diffuse or focal hyperplasia of B cells of Langerhan´s islets that leads to overproduction of insulin. We present
five case reports of patients with different causes of endogenous hyperinsulinemic hypoglycemia. In three cases
there was confirmed insulinoma in two cases nesidioblastosis and congenital suspected hyperinsulinism were found.