The man is 30 years old, as it happens for the first Time: He walks disoriented through the house, not able to control the movements of his arms and is talking nonsense. After all, he can tell his wife that he sees everything only a blur. Half an hour later, the nightmare is over, the man is recovering. In the Episode he can’t remember. Medical help the US citizens do not seek.
Four years, then it happens again. Only once or twice a year, then more frequently. Finally, the now-36-Year-old every two to four weeks of such dropouts. Usually they occur after evenings, he drank beer. Phase way, he drinks per week several times per five to six Beers, then he throttles his evening consumption to two to four Beers. But the dropouts remain. The man who works at the fire Department, blames it on Stress and continues to not to the doctor.
A friend brings the man to the emergency room
One day, he is completely out of the house, because one of his daughters is sick. His wife, as he was not himself. Again he is talking nonsense, his hands twitching. He is now recovering a bit after he eats dinner. But the next day he needs to pass in the morning and is confused then the day again and again in a phased manner. This gets a boyfriend and finally meets an important decision: He brings him to the emergency room of the Massachusetts General Hospital in Boston.
In the hospital arrived, the man still confused and excited. He can’t tell the Doctors how he is and where he is, but knows what day it is. Attention, concentration, memory and abstract Thinking seem to be reduced.
The Patient has a slightly elevated blood pressure. Temperature, heart rate, and respiratory rate are normal. He takes no medications, smokes for 14 years, no more cigarettes and consumed no illegal drugs. 13 years ago, the man had to be operated because he suffered from a chronic inflammation of the esophagus. Eleven years ago he had as a result of a stab wound in the abdomen in addition, a further OP. But this may explain his current problems?
Little sugar in the blood
A blood test a trace: the value of The so-called C-reactive Protein is increased, which may suggest, among other things, on an inflammation. In addition, his blood sugar level is too low – the husband is severely hypoglycemic. The physicians administered to him intravenously with a sugar solution to fix this. His mental state normalized.
no longer Is the blood sugar level is too low, the brain cells enough food – that explains the symptoms of the man. Hypoglycemia can be extremely dangerous, because you can also damage the cardiovascular System, Sufferers may even fall into a coma.
The Doctors want to find out why the man is apparently always under-sugared, as they report in the journal “NEJM”. Generally, this can be a result of severe diseases, such as liver or kidney failure. But so sick of the man is not, each of these possibilities fall away. Also anorexia can be behind it, but the Patient is normal weight and has lost in the past few years, no weight. Similarly, alcohol consumption is a possible cause of low blood sugar – the Doctors suspect that the patient has the Latter is the case.
Probably there’s something wrong with his Insulin-household, to take the medicine. Basically, the blood sugar levels drop, if the pancreas releases this metabolic hormone. Because Insulin allows muscle and fat cells sugar from the blood. Very much Insulin is in the bloodstream, and travels of the sugar in a larger amount in the cells of the body and the sugar level in the blood drops dangerously.
MORE on THE TOPIC of An enigmatic Patient of Dangerous to Believe
In some people the production of Insulin due to an autoimmune disease out of control. Even a benign Tumor in the pancreas can lead to.
To find out what is in the 36-Year-old of the case, the Doctors the patient for several hours of fasting, to measure his blood sugar level, and some other values. After six hours, he’s clearly worse, and his state of mind is again impaired, and the blood sugar value is significantly decreased, which is why the doctors break the fast immediately. Notes on auto-immune disease, you will not find at other blood tests.
track search in the pancreas
The Doctors have an idea: Could a benign, Insulin producing to be a Tumor in the pancreas is the cause? The computer tomography and resonance imaging magnet to produce images of the abdomen of the patient. Clearly you can’t detect whether a so-called Insulinoma in the pancreas.
Only an examination of the body using an ultrasonic probe from the digestive tract shows the Tumor. The Doctors take tissue samples and a short time later, the diagnosis: The man actually has an Insulinoma. This is a benign Tumor that affects women much more often than men, many patients are approximately 50 years old. Why the Insulinoma is grown in the man, don’t know the Doctors.
The surgeons to remove the Tumor from the pancreas and the man is recovering well from the surgery. His blood sugar levels stabilised at a normal level. Seven days later, he can be discharged from the hospital. The Doctors warned him that the Insulinoma may grow in the coming years – but once it goes to the patients well.