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Castillo-López MG, Fernandez MF, Sforza N, Barbás NC, Pattin F, Mendez G, Ogresta F, Gondolesi I, Barros Schelotto P, Musso C, Gondolesi GE. Hyperinsulinemic hypoglycemia in adolescents: case report and systematic review. Clin Diabetes Endocrinol 2022; 8:3. [PMID: 35296370 PMCID: PMC8925193 DOI: 10.1186/s40842-022-00138-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Hyperinsulinemic hypoglycemia is the most common cause of severe and persistent hypoglycemia in neonates and children. It is a heterogeneous condition with dysregulated insulin secretion, which persists in the presence of low blood glucose levels. Case presentation We report a case of a 15 year-old male with hyperinsulinemic hypoglycemia, who underwent a subtotal pancreatectomy after inadequate response to medical therapy. Pathological examination was positive for nesidioblastosis (diffuse β-cell hyperplasia by H-E and immunohistochemical techniques). The patient’s blood glucose levels normalized after surgery and he remains asymptomatic after 1 year of follow-up. The systematic review allowed us to identify 41 adolescents from a total of 205 cases reported in 22 manuscripts, from a total of 454 found in the original search done in PubMed and Lilacs. Conclusions Although very well reported in children, hyperinsulinemic hypoglycemia can occur in adolescents or young adults, as it happens in our reported case. These patients can be seen, treated and reported by pediatricians or adult teams either way due to the wide age range used to define adolescence. Most of them do not respond to medical treatment, and subtotal distal pancreatectomy has become the elected procedure with excellent long-term response in the vast majority.
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Affiliation(s)
- M G Castillo-López
- Diabetes Metabolic department, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - M F Fernandez
- General Surgery, Liver, Intestinal and Pancreas Transplant Services, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - N Sforza
- Diabetes Metabolic department, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - N C Barbás
- Anatomo pathology department, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - F Pattin
- General Surgery, Liver, Intestinal and Pancreas Transplant Services, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - G Mendez
- Oncology department Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - F Ogresta
- Imaxe Radiology Institute, Buenos Aires, Argentina
| | - I Gondolesi
- Medical Student, Facultad de Medicina, Universidad Favaloro, Buenos Aires, Argentina
| | - P Barros Schelotto
- General Surgery, Liver, Intestinal and Pancreas Transplant Services, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - C Musso
- Diabetes Metabolic department, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - G E Gondolesi
- General Surgery, Liver, Intestinal and Pancreas Transplant Services, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina. .,General Surgery Department, and Liver, Pancreas and Intestinal Transplant Units., University Hospital, Favaloro Foundation, Avenida Belgrano 1782, 7mo piso (1093), Buenos Aires, Argentina.
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