The author experienced 2 cases of adult onset of nesidioblastoses, one in a 38 year old male and another in a 58 female.
For the first case, pancreaticoduodenectomy was done removing about 60% of the pancreatic tissue. But the result was not satisfactory due to relapsing bouts of hypoglycemia when the patient had severe diarrea or overexertion, suggesting
inadequate
resection.
For the second case, 85%, distal pancreatectomy was done with complete resolution of symptoms for 3 months but with recurring hypoglycemic episodes thereafter, especially during a fasting period, suggesting pancreatic islet cell regeneration or
proliferation.
We treated these two cases of persisting and recurrent hyperinsulinism with somatostatin analogue 201-995 for four months for the first case and three months for the second case and achieved long term cures for two years and oe and a half years
up
to
the present, respectively.
The blood insulin, C-peptide and PP have remained in the normal range and fasting blood glucoses have remained around 80 mg/dl and fasting I-G ratio below 0.4.
From these results, we inferred that the Somatostatin analogue 201=995 not only has a suppressing effect on the islet cell's secreting function but also has a suppressing and deterring effect on cellular growth itself, suggesting some kind of
antineoplastic activity.
We strongly believe that further clinical and experimental study is necessary.
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