Laparoscopic diagnosis and cure of hyperinsulinism in two cases of focal adenomatous hyperplasia in infancy.
Persistent hyperinsulinemic hypoglycemia of infancy or congenital hyperinsulinism of the neonate is a rare condition that may cause severe neurologic damage if the disease is unrecognized or inadequately treated. Current treatment aims to restore normal blood glucose levels by providing a carbohydrate-enriched diet and drugs that inhibit insulin secretion. If medical treatment fails, then surgery is required. Because congenital hyperinsulinism may be caused either by diffuse involvement of pancreatic beta-cells or by a focal cluster of abnormal beta-cells, the extent of pancreatectomy varies. We report on 2 patients with a focal form of the disease for whom diagnosis was made with laparoscopy. Laparoscopic enucleation of the lesion was curative.
Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands. m.devroede@wkz.azu.nl
Monique
M
De Vroede
N M A
NM
Bax
Klaus
K
Brusgaard
Mark J
MJ
Dunne
Floris
F
Groenendaal
D044903:Congenital Hyperinsulinism / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D010179:Pancreas / Q000473:pathology* / Q000601:surgery; D017354:Point Mutation