Q) Whipple's triad is seen in which pathological condition?
Whipple's triad is seen in pancreatic insulinoma and consists of
a) Symptoms of hypoglycemia
b) Fasting sugar less than 50 mg%
c) Relief of symptoms with administration of dextrose solution
- Insulinoma is the most common functioning pancreatic neuroendocrine tumor
- Symptoms are present for many years before diagnosis
- Weight gain is common
- Distribution of insulinomas is equal in body head and tail
- Average size of insulinoma is 1-1.5 cm
Symptoms of Insulinoma
The neuroglycopenic symptoms of insulinoma included confusion, visual change, and unusual behavior
Sympathoadrenal symptoms may include palpitations, diaphoresis, and tremulousness.
Whipple's triad is just a part of Insulinoma and is not pathognomic of it. This entity may also be seen in other hyperinsulinemic conditions.
For endogenous Insulinoma, following tests are done
Proinsulin above 5.0 pmol/L
insulin above 3.0 pmol/L,
C-peptide above 0.2 nmol/L
all demonstrate endogenous hyperinsulinemia