Nesidioblastosis is a controversial medical term for

hyperinsulinemic hypoglycemia Hyperinsulinemic hypoglycemia describes the condition and effects of low blood glucose caused by excessive insulin. Hypoglycemia due to excess insulin is the most common type of serious hypoglycemia. It can be due to endogenous or injected insulin ...

attributed to excessive insulin production by

pancreatic The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an endocr ...

beta cell Beta cells (β-cells) are a type of cell found in pancreatic islets that synthesize and secrete insulin and amylin. Beta cells make up 50–70% of the cells in human islets. In patients with Type 1 diabetes, beta-cell mass and function are di ...

s that have an abnormal

microscopic The microscopic scale () is the scale of objects and events smaller than those that can easily be seen by the naked eye, requiring a lens or microscope to see them clearly. In physics, the microscopic scale is sometimes regarded as the scale be ...

appearance. The term was coined in the first half of the 20th century. The abnormal microscopic features of the tissue included the presence of islet cell enlargement,

pancreatic islet The pancreatic islets or islets of Langerhans are the regions of the pancreas that contain its endocrine (hormone-producing) cells, discovered in 1869 by German pathological anatomist Paul Langerhans. The pancreatic islets constitute 1–2% of ...

cell

dysplasia Dysplasia is any of various types of abnormal growth or development of cells (microscopic scale) or organs ( macroscopic scale), and the abnormal histology or anatomical structure(s) resulting from such growth. Dysplasias on a mainly microscopi ...

, beta cells budding from

ductal Lafarge is a French industrial company specialising in cement, construction aggregates, and concrete. It is the world's largest cement manufacturer. It was founded in 1833 by Joseph-Auguste Pavin de Lafarge and is a part of the Holcim Group. ...

epithelium, and islets in close proximity to ducts. By the 1970s, nesidioblastosis was primarily used to describe the pancreatic dysfunction associated with persistent

congenital hyperinsulinism Congenital hyperinsulinism is a medical term referring to a variety of congenital disorders in which hypoglycemia is caused by excessive insulin secretion.update 2013 Congenital forms of hyperinsulinemic hypoglycemia can be transient or persist ...

and in most cases from the 1970s until the 1980s it was used as a synonym for what is now referred to as congenital hyperinsulinism. Most congenital hyperinsulinism is now known to be caused by different mechanisms than excessive proliferation of beta cells in a fetal pattern, and the term fell into disfavor after it was recognized in the late 1980s that the characteristic tissue features of nesidioblastosis were sometimes seen in pancreatic tissue from normal infants and even from adults, and are therefore not consistently associated with hyperinsulinemic hypoglycemia. In recent years, the term has been revived to describe a form of ''acquired'' hyperinsulinism with beta cell hyperplasia found in adults, especially after gastrointestinal surgery. Evidence of mechanisms explaining the ability of

weight loss surgery Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through the standard of care procedures ( Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversio ...

to induce modern-day nesidioblastosis has yet to be found; any such mechanisms are of intense interest to

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

researchers.

References

External links

{{Medical resources , DiseasesDB = 8922 , ICD10 = , ICD9 = {{ICD9, 251.9 , ICDO = , OMIM = 601820 , OMIM_mult = {{OMIM, 256450, , none , MedlinePlus = , eMedicineSubj = ped , eMedicineTopic = 1565 , MeshID = D046768
Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass Surgery
Disorders of endocrine pancreas

See also

References

External links