Objective: To report three cases of insulinoma associated with pregnancy.
Design: Case report.
Setting: Divisions of Endocrinology and Gastroenterologic Surgery, Hospital de Clínicas, University of Buenos Aires, Argentina.
Patient(s): Three patients with hypoglycemic signs due to insulinoma appearing during pregnancy or shortly after delivery.
Intervention(s): Laparoscopic excision of insulinoma in two and laparotomy in one of the patients were performed after the end of their pregnancies.
Main outcome measure(s): Disappearance of hypoglycemic crises and histologic proof of insulinomas.
Result(s): In two of the three patients, hypoglycemia occurred within 2-12 weeks after delivery, suggesting that signs could have been masked because of metabolic changes during gestation; in the third patient, hypoglycemia appeared in the first trimester but was misinterpreted.
Conclusion(s): Insulinoma is often not suspected during the first trimester of pregnancy because signs resemble episodes of hypotension or emesis. Later, with the increase in insulin resistance, symptoms subside.