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All Journal Medical Journal of Indonesia Abdimas Umtas : Jurnal Pengabdian kepada Masyarakat The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Hasan Maulahela
Division Of Gastroenterology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Indonesia /Dr. Cipto Mangunkusumo General National Hospital, Jakarta
Religion Agriculture, Biological Sciences & Forestry Arts Education Health Professions Medicine & Pharmacology Public Health Social Sciences

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Detection of Small Lesion Insulinoma with 68Ga-DOTATATE PET/CT scan: A Case Report Irma Wahyuni; Tri Juli Edi Tarigan; Hendra Budiawan; Alvita Dewi; Rian Hidayatullah; Hasan Maulahela
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolism and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i1.40

Abstract

Endogenous hyperinsulinism is a rare condition characterized by inappropriate insulin secretion, with insulinoma accounting for approximately 55% of cases. A 36-year-old woman presented with recurrent hypoglycemic episodes for 4.5 years, particularly in the morning, relieved by glucose intake. Laboratory findings during a supervised fasting test revealed a blood glucose of 44 mg/dL, elevated insulin (15 μIU/mL), C-peptide (2.27 ng/mL), proinsulin (53.1 pmol/L), and suppressed beta-hydroxybutyrate (0.1 mmol/L), indicating endogenous hyperinsulinemia. Initial imaging modalities including CT, MRI, and EUS failed to localize the lesion. The patient discontinued investigation but resumed a year later with nuclear imaging studies. A 99mTc-HYNIC-TOC scan was inconclusive, but subsequent ^68Ga-DOTATATE PET/CT at Hasan Sadikin Hospital revealed a somatostatin receptor-expressing nodule at the pancreatic head, consistent with insulinoma. Given the lesion's location and imaging findings, treatment options were discussed, including Whipple’s procedure versus radiofrequency ablation. Insulinomas are typically small, with 80% under 2 cm and 40% under 1 cm, often making localization challenging. While CT and MRI have detection rates of 70% and 86% respectively, the combination of CT and EUS may reach 100% sensitivity. In cases where conventional imaging is inconclusive, ^68Ga-DOTATATE PET/CT provides a valuable alternative, capable of detecting neuroendocrine tumors as small as 6 mm. This case highlights the critical role of nuclear medicine in localizing elusive insulinomas and guiding definitive treatment.
Beta-1,3/1,6-D-Glucan Extracted from Ganoderma lucidum as Adjunct Therapy in Ulcerative Colitis: A Case Series Saskia Aziza Nursyirwan; Marcellus Simadibrata; Rabbinu Rangga Pribadi; Virly Nanda Muzelina; Hasan Maulahela; Amanda Pitarini Utari; Enrik John Aguila; Ardhia Fefrine Indarta
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026204-211

Abstract

The management of ulcerative colitis is primarily focused on the prevention of complications, remission sustenance, and enhancement of overall quality of life. However, long-term use of various pharmacological therapies can be associated with several side effects, including myelosuppression, hepatitis, lupus-like syndrome, and an increased risk of malignancy. These limitations have led to the search for safer therapeutic options, including bioactive compounds such as Beta-1,3/1,6-D-Glucan with immunomodulatory properties. Ganoderma lucidum contains Beta-1,3/1,6-D-Glucan as a principal bioactive compound extracted from its mycelium. Despite the broad therapeutic properties, exploration into its role specifically for ulcerative colitis patients remains scarce. Therefore, this case series aimed to explore the potential role of Beta-1,3/1,6-D-Glucan derived from Mycelium extract of Ganoderma lucidum in managing ulcerative colitis.
Co-Authors Achmad Fauzi ACHMAD FAUZI Achmad Fauzi Achmad Fauzy, Achmad Adityo Susilo, Adityo Alvita Dewi Amanda P Utari, Amanda P Amanda Pitarini Utari Anjar Raraswati Anna Ariane, Anna Ardani, Yanuar Ardhia Fefrine Indarta Ari F Syam Ari F Syam Ari Fahrial Syam Arif Mansjoer Aulia Rizka, Aulia Brian Eka Rahman C Rinaldi A Lesmana Cleopas Martin Rumende Dadang Makmun Dedy G Sudrajat Destini, Mulia Diana Sunardi Dinda Nisrina E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Enrik John Aguila Esa, Dekta Filantropi Evy Yunihastuti Faisal, Edward Firman, Fauzan Hertrisno Gurmeet Singh Harianja, Gerald Abraham Hendra Budiawan Hilda Nurmalihah Ikhwan Rinaldi Irma Wahyuni Irvianita, Vinandia Isabela Andhika Paramita Isna Mahmudah Jaffray DP Rambak Juferdy Kurniawan Kaka Renaldi Kevin Winston Kuntjoro Harimurti Lazuardi G Ilhami Lusiani Lusiani, Lusiani Marcellus Simadibrata K Maureen Irawati Koesnadi Mira Yulianti, Mira Muhammad Miftahussurur Murdani Abdullah Naufali Rizkiawan Noto Dwimartutie Nur Atikah Paramita, Isabela Andhika Purwita Wijaya Laksmi Rabbinu Rangga Pribadi Raditya Dewangga Rahmat Cahyanur Rian Hidayatullah Roy Soetikno Rudi Putranto Rudy Hidayat Rumagesan, Djahalia Sabrina Munggarani Yusuf Samudra Andi Yusuf Saskia Aziza Nursyirwan Sepmeitutu, Iwandheny Syahidatul Wafa, Syahidatul Tandan, Manu Thamrin, Husin Tri Juli Edi Tarigan Triyanta Yuli Pramana Virly Nanda Muzelina Winston, Kevin Yoshio Yamaoka Yudith Annisa Ayu Rezkitha, Yudith Annisa Ayu Zulkifly, Steven