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J Pediatr Endocrinol Metab ; 29(10): 1187-1194, 2016 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-27682711

RESUMO

BACKGROUND: Congenital hyperinsulinism (CHI) is a rare disease with an estimated incidence of 1:40,000 live births. Here, we characterize 11 patients treated at Munich Children's Hospital Schwabing. METHODS: We analyzed data on birth, treatment and laboratory results including genetic testing and evaluated the long-term course with a follow-up visit. RESULTS: All patients had severe, diazoxide-(DZX)-resistant hypoglycemia, beginning immediately after birth. Two patients were treated by medical therapy, eight underwent subtotal pancreatectomy and one had a partial resection. Both patients who had medical therapy still suffer from occasional hypoglycemia. Six patients with subtotal pancreatectomy were affected by mild hypoglycemia. Seventy-five percent of patients who had surgical treatment developed diabetes mellitus (DM) at a median age of 10.5 (8-13) years. In 89% of patients with available genetic testing, mutations of the ABCC8 gene were detected. CONCLUSIONS: The majority of CHI-patients not responding to DZX underwent surgery. After subtotal pancreatectomy, patients typically developed diabetes around early puberty.


Assuntos
Biomarcadores/metabolismo , Hiperinsulinismo Congênito/genética , Diabetes Mellitus/etiologia , Hipoglicemia/etiologia , Mutação/genética , Receptores de Sulfonilureias/genética , Adolescente , Adulto , Criança , Hiperinsulinismo Congênito/complicações , Análise Mutacional de DNA , Diabetes Mellitus/tratamento farmacológico , Feminino , Seguimentos , Perfilação da Expressão Gênica , Testes Genéticos , Humanos , Hipoglicemia/tratamento farmacológico , Insulina/sangue , Masculino , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Adulto Jovem
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