Glucocorticoid Therapy and Miglitol Ameliorate Reactive Hypoglycemia Secondary to Late Dumping Syndrome.
Manabu Saito, Hiroshi Uchino, Arisa Yoshida et al.
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Case in brief
A 73-year-old man developed symptomatic reactive hypoglycemia attributed to late dumping syndrome after esophagectomy with gastric tube reconstruction. Frequent dietary management and voglibose, a non-absorbable α-glucosidase inhibitor, did not control the hypoglycemia. After treatment was changed to low-dose prednisolone and miglitol, an absorbable α-glucosidase inhibitor, the hypoglycemia improved and his symptoms resolved.
What made this case unusual
Hypoglycemia persisted despite dietary management and voglibose, but improved after switching to low-dose prednisolone and miglitol.
Diagnostic / clinical pearl
In this reported case, late dumping syndrome caused reactive hypoglycemia after esophagectomy; persistent symptoms despite dietary measures and voglibose improved with low-dose prednisolone and miglitol.