Ramos E, Baron S, Sentanac S, Touati G, Picherot G
Service de pédiatrie, hôpital de la mère et de l'enfant, quai Moncousu, Nantes, France.
Arch Pediatr. 2005 Jul;12(7):1109-11. doi: 10.1016/j.arcped.2005.03.047.
In children more than 8 years old, hyperinsulinism is the most common cause of hypoglycemia.
We report the case of an 11-year-old girl who presented recurrent hypoglycemia with endogenous hyperinsulinism (high insulin and C-peptide concentrations). The morphological investigations didn't find insulinoma. Finally the questioning identifies the voluntary intoxication with hypoglycemic agent. At a later date, the sulfonylurea dosage during an hypoglycaemic episode was positive.
The sulfonylurea drugs can mimic an endogenous hyperinsulinism and mislead the diagnostic to an insulinoma suspicion and lead to a surgical exploration. A sulfonylurea dosage should be done before planning out surgery.
在8岁以上儿童中，高胰岛素血症是低血糖最常见的原因。
我们报告一例11岁女孩，出现反复低血糖伴内源性高胰岛素血症（胰岛素和C肽浓度升高）。形态学检查未发现胰岛素瘤。最终通过询问确定为服用降糖药导致的故意中毒。之后，低血糖发作时磺脲类药物检测呈阳性。
磺脲类药物可模拟内源性高胰岛素血症，误导诊断为疑似胰岛素瘤并导致手术探查。在计划手术前应进行磺脲类药物检测。
