Abstract
The materials for our study consisted of pancreatic specimens collected surgically from tvo patients with a new type of spontaneous hypoglycemia. They possessed insulin-binding auto-antibodies without previous history of insulin injection and suffered from severe hypoglycemic attacks.
Case 1 was a 52-year-old male and had had hypoglycemic attacks for 5 years. In the pancreas excised surgically the number of islets per square centimeter of pancreatic tissue was 440-714 and the proportion of islets in pancreatic tissue was 2.9-5.5%, although the normal ranges of the number of islets and proportion of islets reported by Gepts were 53-649 and 0.51-3.09% respectively. Reduction of granules of B cells, fibrosis of islets and dilatation of capillaries in the islets were significant.
Case 2 was a 61-year-old male, and the pancreatectomy of this patient was carried out after a period of 9 months of spontaneous hypoglycemic attacks. The number of islets per square centimeter of pancreatic tissue was 391-616, and the proporton of illets in pancreatic tissue was 8.3-12.2%. Hyperplasia of islet cells and hypertrophy of islets were significant in Case 2, and islets were filled with well granulated B cells. Scattered stomal infiltration of lymphocytes with germinal center formation was found in the exocrine pancreas.
Although it is difficult to prove that the histological changes of the pancreas of these patients are caused by insulin-autoimmunity, insulin-binding antibodies it; the scrum might stimulate the islets directly or indirectly in these cases. Some of differences of qualitative changes in the islets between Case 1 and Case 2 might be related to the different length of the period of hypoglycemic attacks before pancreatectomy.
