[Persistent hyperinsulinemic hypoglycemia in the newborn and infants]

Arch Pediatr. 1998 Dec;5(12):1347-52. doi: 10.1016/s0929-693x(99)80055-4.
[Article in French]

Abstract

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is the most frequent cause of hypoglycaemia in infancy. Clinical presentation is heterogeneous, with variable onset of hypoglycaemia and response to diazoxide, and presence of sporadic or familial forms. Underlying histopathological lesions can be focal or diffuse. Focal lesions are characterised by focal hyperplasia of pancreatic islet-like cells, whereas diffuse lesions implicate the whole pancreas. The distinction between the two forms is important because surgical treatment and genetic counselling are radically different. Focal lesions correspond to somatic defects which are totally cured by limited pancreatic resection, whereas diffuse lesions require a subtotal pancreatectomy exposing to high risk of diabetes mellitus. Diffuse lesions are due to functional abnormalities involving several genes and different transmission forms. Recessively inherited PHHI have been attributed to homozygote mutations for the beta-cell sulfonylurea receptor (SUR1) or the inward-rectifying potassium-channel (Kir6.2) genes. Dominantly inherited PHHI can implicate the glucokinase gene, particularly when PHHI is associated with diabetes, the glutamate dehydrogenase gene when hyperammonaemia is associated, or another locus.

Publication types

  • Comparative Study
  • English Abstract
  • Review

MeSH terms

  • Diazoxide / therapeutic use
  • Diuretics
  • Genetic Counseling
  • Humans
  • Hyperinsulinism* / etiology*
  • Hyperinsulinism* / genetics
  • Hyperinsulinism* / therapy
  • Hypoglycemia / etiology*
  • Infant
  • Infant, Newborn
  • Pancreatectomy
  • Pancreatic Diseases* / genetics
  • Pancreatic Diseases* / therapy
  • Sodium Chloride Symporter Inhibitors / therapeutic use

Substances

  • Diuretics
  • Sodium Chloride Symporter Inhibitors
  • Diazoxide