OBJECTIVE: To report three cases of insulinoma associated with pregnancy. DESIGN: Case report. SETTING: Divisions of Endocrinology and Gastroenterologic Surgery, Hospital de Clínicas, University of Buenos Aires, Argentina. PATIENT(S): Three patients with hypoglycemic signs due to insulinoma appearing during pregnancy or shortly after delivery. INTERVENTION(S): Laparoscopic excision of insulinoma in two and laparotomy in one of the patients were performed after the end of their pregnancies. MAIN OUTCOME MEASURE(S): Disappearance of hypoglycemic crises and histologic proof of insulinomas. RESULT(S): In two of the three patients, hypoglycemia occurred within 2-12 weeks after delivery, suggesting that signs could have been masked because of metabolic changes during gestation; in the third patient, hypoglycemia appeared in the first trimester but was misinterpreted. CONCLUSION(S): Insulinoma is often not suspected during the first trimester of pregnancy because signs resemble episodes of hypotension or emesis. Later, with the increase in insulin resistance, symptoms subside.
OBJECTIVE: To report three cases of insulinoma associated with pregnancy. DESIGN: Case report. SETTING: Divisions of Endocrinology and Gastroenterologic Surgery, Hospital de Clínicas, University of Buenos Aires, Argentina. PATIENT(S): Three patients with hypoglycemic signs due to insulinoma appearing during pregnancy or shortly after delivery. INTERVENTION(S): Laparoscopic excision of insulinoma in two and laparotomy in one of the patients were performed after the end of their pregnancies. MAIN OUTCOME MEASURE(S): Disappearance of hypoglycemic crises and histologic proof of insulinomas. RESULT(S): In two of the three patients, hypoglycemia occurred within 2-12 weeks after delivery, suggesting that signs could have been masked because of metabolic changes during gestation; in the third patient, hypoglycemia appeared in the first trimester but was misinterpreted. CONCLUSION(S): Insulinoma is often not suspected during the first trimester of pregnancy because signs resemble episodes of hypotension or emesis. Later, with the increase in insulin resistance, symptoms subside.