[Somatostatin in the emergency treatment of persistent hypoglycemias caused by hyperinsulinism (nesidioblastosis of the pancreas)].
11 infants with persisting hypoglycemia due to hyperinsulinism (nesidioblastosis of the pancreas) were treated with somatostatin. Somatostatin administration in a relatively high dosage (initially 145 micrograms/m2 body surface as bolus followed by a continuous infusion of the same dose per hour) resulted in a suppression of the circulating insulin concentration leading to a less abrupt fall of the postprandial plasma glucose level. By somatostatin infusion we were able to keep two patients with intractable neonatal hypoglycemia in a normoglycemic state until subtotal pancreatectomy. Infants suffering from nesidioblastosis require 1.0-4.5 micrograms/kg/h somatostatin and a concomitant carbohydrate supply of 0.3-0.48 g/kg/h in order to maintain normoglycemia. An initial somatostatin bolus can be omitted. Somatostatin is very reliable in the treatment of neonatal hypoglycemia due to hyperinsulinism for a limited period of time until subtotal pancreatectomy is performed. In most cases of nesidioblastosis this operative measure seems to be inevitable for the control of hyperinsulinism.
Wendel
U
U
Kardorff
C
C
Dorittke
P
P
Bremer
H J
HJ
D003131:Combined Modality Therapy; D004630:Emergencies; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D007003:Hypoglycemia / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications*; D013004:Somatostatin / Q000627:therapeutic use*
D007328:Insulin; D013004:Somatostatin
Somatostatin zur Notfallbehandlung bei persistierenden Hypoglykämien aufgrund eines Hyperinsulinismus (Nesidioblastose des Pankreas).