The use of the plasma epinephrine response in the diagnosis of idiopathic postprandial syndrome
S. A. Chalew, J. V. McLaughlin, J. H. Mersey, A. J. Adams, M. Cornblath and A. A. Kowarski
Patients with idiopathic postprandial syndrome (IPS) report recurrent
postprandial episodes that resemble the clinical manifestations of
hypoglycemia. In an effort to find objective criteria for diagnosis of IPS,
we studied a group of patients with IPS and controls during an oral glucose
tolerance test. Patients with IPS had a significantly lower mean glucose
nadir and higher hypoglycemic index than controls. Although 74% of patients
with IPS had glucose nadirs higher than 50 mg/dL, their responses of
epinephrine, cortisol, growth hormone, glucagon, and norepinephrine were
significantly higher than the respective changes in the controls. Of the
five hormones, only the epinephrine response separated the patients from
the controls without overlap. The epinephrine response may represent a
valuable diagnostic criterion for this disorder.
