Persistent hypoglycemia in a child with a gastrocolic fistula--an unexpected presentation of leucine-sensitive hypoglycemia.
Leucine-hypersensitive hypoglycemia is a rare clinical entity that is usually diagnosed after an exhaustive search for other causes of hypoglycemia. In nonsurgical patients, an imbalance between metabolic demands and gluconeogenesis are most frequently responsible for recurrent symptomatic hypoglycemia. In the postoperative patient, hypoglycemia more commonly results from inadequate energy intake or malabsorption from functional or anatomical abnormalities. Presented here is an unusual case of a child who was initially diagnosed with postoperative gastrocolic fistula and dumping syndrome as the cause of hypoglycemia but later found to have leucine-hypersensitive hypoglycemia.
Lee
David D
DD
Department of General Surgery, Rush University Medical Center, Chicago, Ill 60612, USA.
Hollinger
Edward F
EF
Kim
Anthony W
AW
Holterman
Mark J
MJ
D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002908:Chronic Disease; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis*; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis; D007003:Hypoglycemia / Q000175:diagnosis* / Q000209:etiology; D033162:Incidental Findings; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis*; D007930:Leucine / Q000276:immunology; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index
D001786:Blood Glucose; D007930:Leucine