Persistent hyperinsulinaemic hypoglycaemia.

Abstract

Congenital hyperinsulinism (CI) is the most important cause of hypoglycaemia in early infancy. The inappropriate oversecretion of insulin is responsible for profound hypoglycaemias which require aggressive treatment to prevent severe and irreversible brain damage. Hypoglycaemia have a neonatal or infancy onset. Medical treatment with diazoxide is first used to treat CI, but patients who are medically resistant (mostly of neonatal-onset) require pancreatectomy. CI is a heterogeneous disorder with two histopathological lesions, diffuse and focal which are clinically indistinguishable. Only diazoxide-sensitive neonates should be orientated to transient hyperinsulinism or hyperinsulinism-hyperammonemia syndrome. Focal CI is characterized by a sporadic somatic islet-cell hyperplasia. Diffuse CI corresponds to a functional abnormality of insulin secretion in the whole pancreas and involves several genes with different transmissions. The knowledge of both focal and diffuse lesions is very important. Focal lesions are effectively treated by limited pancreatic resection while diffuse lesions which are unresponsive to drug or dietary treatment require extensive pancreatectomy with high risk of diabetes mellitus.

• Authors: Pascale de Lonlay, Guy Touati, Jean-Jacques Robert, Jean-Marie Saudubray
• Journal: Seminars in neonatology : SN (Semin Neonatol) Vol. 7 Issue 1 Pg. 95-100 (Feb 2002) ISSN: 1084-2756 [Print] Netherlands
• PMID: 12069542 (Publication Type: Journal Article, Review)
• Copyright: Copyright 2002 Published by Elsevier Science Ltd.

Chemical References

• Diuretics
• Sodium Chloride Symporter Inhibitors
• Diazoxide

Topics

• Diazoxide (therapeutic use)
• Diuretics
• Humans
• Hyperinsulinism (complications, diagnosis, genetics, therapy)
• Hypoglycemia (etiology)
• Infant, Newborn
• Pancreatectomy
• Prognosis
• Sodium Chloride Symporter Inhibitors (therapeutic use)