[Persistent hyperinsulinemic hypoglycemia. Two case reports].
We report two cases of infants who presented seizures and persistent hypoglycemia. In both infants, we established diagnosis of persistent hypoglycemia by hyperinsulinism (PHH); glycemic/insulinic ratio was > 0.3, and we found no pancreatic changes by means of other diagnostic procedures. The medical treatment consisted of hydrocortisone, diazoxide, and octreotide without response. Definitive treatment made was sub-total pancreatectomy; postoperatory evolution was satisfactory, and the histologic report showed changes in Langerhans islet of nesidioblastosis. We conclude that PHH and glucose/insulin ratio > 0.3 indicates that surgical treatment with pancreatectomy should not be delayed.
Sotelo-Cruz
Norberto
N
Servicio de Medicina Interna, Hospital Infantil del Estado de Sonora. nsotelo@hmo.megared.net.mx
Cordero-Olivares
Andrés
A
Ramírez-Rodríguez
Carlos
C
López-Cervantes
Guillermo
G
Hurtado-Valenzuela
Jaime
J
López-Cervantes
Brenda María
BM
D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D007003:Hypoglycemia / Q000150:complications*; D007223:Infant; D007231:Infant, Newborn; D008297:Male