Villatoro-Fernández JL, Augusto Ordóñez E, Gómez-Guillermoprieto L, Bonilla-Merino A, Ortiz-Torres G, Jiménez-Urueta PS

Language: Spanish
References: 20
Page: 114-117
PDF size: 88.85 Kb.

ABSTRACT

Introduction: Hyperinsulinism is a rare cause of severe persisten hypoglycemia in the newborn and infant. It is associated with a high incidence of brain damage and mental retardation as a consequence of repeated episodes of hypoglycemia.
Case report: A 3 month-old male child presented seizures secondary to intractable hypoglycemia. Clinical and biochemical criteria were suggestive of hyperinsulinism. The report of a biopsy indicated diffuse hyperplasia of insular cells of the pancreas. The patient was operated for elective subtotal pancreatectomy, with successful outcome, i.e., reversion of hypoglycemia. However brain damage and mental retardation persisted. These facts show the importance of early diagnosis and treatment of this condition.
Discussion: Hyperinsulinism must be suspected in newborns with persistent hypoglycemia. Symptoms in infants are less frequent and therefore diagnosis is diffi cult and a higher degree of suspicion is required. Early diagnosis precludes serious neurological sequelae. In the absence of most common causes of hypoglycemia such as sepsis, it is important to have this condition in mind in the differential diagnosis.

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