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Loss of consciousness in a helicopter pilot as plausible first sign of insulinoma: a case report

Loss of consciousness in a helicopter pilot

Authors

  • Simone Pratò UO Medicina del Lavoro, Clinica del Lavoro L Devoto, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico via F. Sforza 35, 20122 Milan, Italy; Postgraduate School of Occupational Medicine, University of Milan
  • Vittoria Didonna UO Medicina del Lavoro, Clinica del Lavoro L Devoto, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico via F. Sforza 35, 20122 Milan, Italy; Postgraduate School of Occupational Medicine, University of Milan; Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan
  • Francesca Garletti UO Medicina del Lavoro, Clinica del Lavoro L Devoto, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico via F. Sforza 35, 20122 Milan, Italy; Postgraduate School of Occupational Medicine, University of Milan
  • Giovanni Marfia Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan
  • Adriano Barbaresi Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan
  • Fabrizio Palumbo Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan
  • Emanuele Garzia Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan
  • Giuseppe Ciniglio Appiani
  • Luciano Riboldi UO Medicina del Lavoro, Clinica del Lavoro L Devoto, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico via F. Sforza 35, 20122 Milan, Italy
  • Luisella Vigna UO Medicina del Lavoro, Clinica del Lavoro L Devoto, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico via F. Sforza 35, 20122 Milan, Italy

DOI:

https://doi.org/10.23749/mdl.v112i6.12037

Keywords:

occupational, Pilot, NET, insulinoma, curcumin

Abstract

A 50-year-old man who worked as a helicopter rescue pilot transiently lost consciousness while piloting a helicopter rescue. In the diagnostic process, all tests for the main possible differential diagnoses of loss of consciousness (cardiological and neurological) were performed and yielded normal results. Blood chemistry tests revealed recurrent fasting hypoglycemia and Chromogranin A was at the upper limit of normal. Fine needle aspiration guided by endoscopic ultrasonography was used to diagnose insulinoma-type neuroendocrine tumor of the pancreas. According to the Italian policies, the occupational physician aims to maintain professional skills without neglecting flight safety. A careful analysis of the relationship between the characteristics of the state of health of the aviator and his specific work needs was carried out, and he was given the opportunity to continue working as a rescue pilot thanks to medical therapies associated with organizational interventions in the workplace.

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