Near-total pancreatectomy for hyperinsulinism. Spontaneous remission of resultant diabetes.
Persistent hyperinsulinism in the newborn may warrant surgical intervention to prevent neurologic sequelae. Subtotal pancreatectomy may not be adequate, necessitating near-total pancreatectomy with subsequent development of diabetes mellitus. We report an infant with hyperinsulinemic hypoglycemia who underwent near-total pancreatectomy. The postoperative period was characterized by insulin-dependency and extreme insulin sensitivity. Clinical follow-up and C-peptide determinations showed a return of insulin secretory capacity permitting the discontinuation of insulin therapy after five months. This experience reaffirms the potential for a favorable outcome after near-total pancreatectomy in the newborn period for severe hyperinsulinism.
D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D010180:Pancreatectomy / Q000009:adverse effects*; D012075:Remission, Spontaneous
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin