Document Detail


Persistent hyperinsulinemic hypoglycemia of infancy: long-term outcome following subtotal pancreatectomy.
MedLine Citation:
PMID:  10689636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of persistent hypoglycemia in infants. The current standard treatment is subtotal pancreatectomy (Px). However, the long-term outcome following surgery needs further attention. METHODS: We analyzed 10 children (7 M, 3 F) with PHHI who underwent partial (65-80%) and subtotal (81-95%) Px. Follow-up ranged from 2 to 9.4 yr (mean = 4.2 yr). We divided them into 2 groups based upon the age at onset of hypoglycemia: early (< 1 mo) and late (> or = 1 mo). RESULTS: The seven patients in the early-onset group underwent 85-95% Px between ages of 18 d and 3 mo. Three of them initially treated by 85-90% Px had persistent hypoglycemia postoperatively. Two out of three required a 2nd operation with 95% Px for controlling hypoglycemia, though both still had persistent hypoglycemia and required medication to control blood glucose. The remaining four had 95% Px and had maintained euglycemia postoperatively. One patient developed diabetes 6 yr after surgery. Six of seven patients had delayed development and subnormal IQ. Three patients of the late-onset group (3 mo, 6 mo and 4 yr) underwent partial Px (80%, 65% and 65%, respectively) and maintained euglycemia postoperatively. Despite 65% Px, one developed diabetes 3 yr after surgery. CONCLUSIONS: These results suggest that children with early-onset hypoglycemia have more severe hyperinsulinism than those with late-onset hypoglycemia. The former require 95% Px for maintaining euglycemia, but long-term complications with diabetes may be common. In contrast, the latter require lower percentage Px which may reduce the incidence of diabetes in the future.
Authors:
P Mahachoklertwattana; C Suprasongsin; S Teeraratkul; C Preeyasombat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric endocrinology & metabolism : JPEM     Volume:  13     ISSN:  0334-018X     ISO Abbreviation:  J. Pediatr. Endocrinol. Metab.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-09     Completed Date:  2000-03-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9508900     Medline TA:  J Pediatr Endocrinol Metab     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  37-44     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Blood Glucose / metabolism
Diabetes Mellitus / etiology
Female
Glucose / administration & dosage
Glucose Tolerance Test
Growth Disorders / etiology
Humans
Hyperinsulinism / complications*,  surgery*
Hypoglycemia / complications*,  drug therapy,  surgery*
Infant
Infant, Newborn
Insulin / blood
Male
Mental Retardation / etiology
Pancreatectomy*
Reoperation
Retrospective Studies
Treatment Outcome*
Chemical
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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