{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T06:23:52Z","timestamp":1746512632712},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Justus-Liebig-Universit\u00e4t Gie\u00dfen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Innere Medizin"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Eine 69-j\u00e4hrige Patientin und ein 70-j\u00e4hriger Patient wurden mit rezidivierenden, schweren Hypoglyk\u00e4mien und klinischer Whipple-Trias aufgenommen. Bei der Patientin lie\u00dfen erh\u00f6hte Spiegel an Insulin und C\u2011Peptid, ein pathologischer insulinogener Index und ein Fastentest an ein Insulinom denken, welches im <jats:sup>68<\/jats:sup>Ga-DOTATOC-PET-CT im Pankreasschwanz detektiert wurde. Es bestand eine Koinzidenz mit einem neuroendokrinen Merkel-Zell-Karzinom. Bei dem Patienten zeigten sich hingegen supprimierte Spiegel an Insulin und C\u2011Peptid und es konnte eine tumorassoziierte, paraneoplastische Hypoglyk\u00e4mie infolge IGF-2-Sekretion gesichert werden, mit Nachweis eines erh\u00f6hten Glukoseverbrauchs in der Skelettmuskulatur (<jats:sup>18<\/jats:sup>F\u2011FDG-PET-CT).<\/jats:p>","DOI":"10.1007\/s00108-023-01473-6","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T23:02:31Z","timestamp":1674774151000},"page":"393-400","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Whipple-Trias mit erh\u00f6hten und erniedrigten Insulinspiegeln"],"prefix":"10.1007","volume":"64","author":[{"given":"Thomas","family":"Karrasch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Eul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Gattenl\u00f6hner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fritz","family":"Roller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winfried","family":"Padberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Sch\u00e4ffler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"1473_CR1","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/1477-7819-3-58","volume":"3","author":"J Bachmann","year":"2005","unstructured":"Bachmann\u00a0J, Kleeff\u00a0J et\u00a0al (2005) Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: case report and literature review. 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