A case of persistent hyperinsulinemic hypoglycemia of infancy successfully managed with subcutaneous octreotide injection and nocturnal intravenous glucose supply.
Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is often resistant to medical therapy and is normally treated by subtotal pancreatectomy to avoid neurological complications. However, many problems after surgery, such as recurrence of hypoglycemia and diabetes mellitus, remain to be solved. This report concerns a case of PHHI that was resistant to octreotide or diazoxide alone but was successfully controlled with subcutaneous injection of octreotide in combination with nocturnal glucose infusion through central venous catheter. The patient exhibited natural remission of hyperinsulinism with age, and all treatment was ceased at the age of 4 yr. Growth and neurological development of the patient have been normal. This combined therapy can be a therapeutic option as a substitute for surgical solutions.
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Mari
M
Murakami
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Sotaro
S
Mushiake
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Hiroko
H
Kashiwagi
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Yuri
Y
Etani
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Yoko
Y
Miyoshi
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Keiichi
K
Ozono
Infantile hypoglycemia; hyperinsulinism; nocturnal glucose infusion; octreotide