Rotenstein D, Serbin S, Welsh T
Department of Pediatrics, Medical College of Pennsylvania, Allegheny General Hospital, Pittsburgh 15212.
Pediatrics. 1992 Aug;90(2 Pt 1):212-5.
Treatment for hyperinsulinism in infants and children can be difficult and has included numerous treatment modalities. This paper reports 16 months of palliative treatment with cyproheptadine and diazoxide in a child with hyperinsulinism initially diagnosed at 6 months of age (her insulin level was 80 microU/mL while her glucose level was 38 mg/dL). She continued to have episodes of staring and alteration in level of consciousness while receiving her usual doses of diazoxide (12 mg/kg) alone. Mean nocturnal glucose values, which were quite low during treatment with diazoxide alone, improved significantly with the addition of cyproheptadine to her therapeutic regimen. Fasted C-peptide values, elevated during diazoxide alone, returned to the normal range with combination treatment for 16 months. Cyproheptadine and diazoxide in combination may be useful for treatment of hyperinsulinism that presents after the neonatal period.
婴幼儿高胰岛素血症的治疗可能具有挑战性，且已有多种治疗方式。本文报告了一名最初在6个月大时被诊断为高胰岛素血症的儿童（其胰岛素水平为80微单位/毫升，而血糖水平为38毫克/分升）接受16个月赛庚啶和二氮嗪姑息治疗的情况。在仅接受常规剂量二氮嗪（12毫克/千克）治疗期间，她仍持续出现凝视发作和意识水平改变。仅使用二氮嗪治疗时夜间平均血糖值相当低，在治疗方案中添加赛庚啶后显著改善。仅使用二氮嗪时升高的空腹C肽值，在联合治疗16个月后恢复到正常范围。赛庚啶和二氮嗪联合使用可能对新生儿期后出现的高胰岛素血症治疗有用。
