Insulinoma laboratory tests: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of insulinoma include | Laboratory findings consistent with the diagnosis of insulinoma include serum [[glucose]] < 55 mg/dL<ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155 }} </ref>; serum [[Insulin]] > 5-10 μU/mL; serum [[C-peptide|C-Peptide]] > 200 pmol/L and serum [[proinsulin]] ≥ 22 pmol/L. Patients with insulinoma may have elevated [[insulin]] to [[glucose]] ratio > 0.4, which is usually suggestive of insulinoma after a 72-hour fast test as a [[Gold standard (test)|gold standard]] test. <ref name="pmid18672144">{{cite journal| author=Callender GG, Rich TA, Perrier ND| title=Multiple endocrine neoplasia syndromes. | journal=Surg Clin North Am | year= 2008 | volume= 88 | issue= 4 | pages= 863-95, viii | pmid=18672144 | doi=10.1016/j.suc.2008.05.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18672144 }} </ref> 1/3 rd or 33% patients have clinical symptoms with in 12 hours of the fasting; 80% develop within 24 hours; 90% develop within 48 hours and 100% develop within 72 hours. | ||
Patients with insulinoma may have elevated insulin to glucose ratio >0.4, which is usually suggestive of insulinoma after a 72-hour fast test | |||
1/ | |||
80% develop within 24 hours | |||
90% develop within 48 hours | |||
100% develop within 72 hours | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
*Laboratory findings consistent with the diagnosis of insulinoma include: | *Laboratory findings consistent with the diagnosis of insulinoma include: | ||
** | ** Serum [[glucose]] < 55 mg/dL <ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155 }} </ref> | ||
** | ** Serum [[Insulin]] > 5-10 μU/mL | ||
** | ** Serum [[C-Peptide]] > 200 pmol/L | ||
** | ** Serum [[proinsulin]] ≥ 22 pmol/L | ||
*Patients with insulinoma may have elevated [[insulin to glucose | *Patients with insulinoma may have elevated [[insulin]] to [[glucose]] ratio > 0.4, which is usually suggestive of insulinoma after a 72-hour fast test. It is a gold standard test. <ref name="pmid18672144">{{cite journal| author=Callender GG, Rich TA, Perrier ND| title=Multiple endocrine neoplasia syndromes. | journal=Surg Clin North Am | year= 2008 | volume= 88 | issue= 4 | pages= 863-95, viii | pmid=18672144 | doi=10.1016/j.suc.2008.05.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18672144 }} </ref> | ||
**1/ | **1/3 rd or 33% patients have clinical [[symptoms]] with in 12 hours of the fasting | ||
**80% develop within 24 hours | **80% develop within 24 hours | ||
**90% develop within 48 hours | **90% develop within 48 hours | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of insulinoma include serum glucose < 55 mg/dL[1]; serum Insulin > 5-10 μU/mL; serum C-Peptide > 200 pmol/L and serum proinsulin ≥ 22 pmol/L. Patients with insulinoma may have elevated insulin to glucose ratio > 0.4, which is usually suggestive of insulinoma after a 72-hour fast test as a gold standard test. [2] 1/3 rd or 33% patients have clinical symptoms with in 12 hours of the fasting; 80% develop within 24 hours; 90% develop within 48 hours and 100% develop within 72 hours.
Laboratory Findings
- Laboratory findings consistent with the diagnosis of insulinoma include:
- Serum glucose < 55 mg/dL [1]
- Serum Insulin > 5-10 μU/mL
- Serum C-Peptide > 200 pmol/L
- Serum proinsulin ≥ 22 pmol/L
- Patients with insulinoma may have elevated insulin to glucose ratio > 0.4, which is usually suggestive of insulinoma after a 72-hour fast test. It is a gold standard test. [2]
- 1/3 rd or 33% patients have clinical symptoms with in 12 hours of the fasting
- 80% develop within 24 hours
- 90% develop within 48 hours
- 100% develop within 72 hours
References
- ↑ 1.0 1.1 Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER; et al. (2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
- ↑ 2.0 2.1 Callender GG, Rich TA, Perrier ND (2008). "Multiple endocrine neoplasia syndromes". Surg Clin North Am. 88 (4): 863–95, viii. doi:10.1016/j.suc.2008.05.001. PMID 18672144.