title: Persistent hyperinsulinemic hypoglycemia with left ventricular hypertrophy and dysrhythmia: a case report.
abstract: Persistent hyperinsulinemic hypoglycemia in neonatal period is characterized by insulin hypersecretion. The major feature is severe hypoglycemia, generally unresponsive to routine medical treatment. Subtotal or total pancreatectomy is performed in unresponsive cases. In this case report, we present a newborn with persistent hypoglycemia unresponsive to medical treatment with dysrhythmic left ventricular hypertrophy. The insulin/C-peptide ratio was 58 as a confirmation of diagnosis. Since hypoglycemia persisted after the initial medical treatment, a subtotal pancreatectomy was performed followed by near-total pancreatectomy. A histologic examination revealed diffuse insulin islets. At the 70th post-natal day, death occurred due to heart failure and ventricular dysrhythmia. To our knowledge, severe dysrhythmia and left ventricular hypertrophy in persistent hyperinsulinemic hypoglycemia (PPH) is identified in the patient.
authors.affiliation: Sisli Children Hospital, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Bulbul
authors.forename: Fatih
authors.initials: F
authors.lastname: Bolat
authors.forename: Serdar
authors.initials: S
authors.lastname: Comert
authors.forename: Hilmi
authors.initials: H
authors.lastname: Demirin
authors.forename: Canan
authors.initials: C
authors.lastname: Tanik
authors.forename: Lida
authors.initials: L
authors.lastname: Bulbul
authors.forename: Asiye
authors.initials: A
authors.lastname: Nuhoglu
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Dokucu
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002096:C-Peptide / Q000097:blood; D044903:Congenital Hyperinsulinism / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D017809:Fatal Outcome; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D008297:Male; D010179:Pancreas / Q000473:pathology*; D010180:Pancreatectomy
chemical_list: D002096:C-Peptide; D007328:Insulin