Dekelbab Bassem H, Sperling Mark A
Children's Hospital of Pittsburgh, Division of Endocrinology, Pittsburgh, PA 15213, USA.
Acta Paediatr. 2006 Oct;95(10):1157-64. doi: 10.1080/08035250600640414.
Hyperinsulinemia-induced hypoglycemia is the most common cause of persistent hypoglycemia in adults, children, and infants. Our understanding of the disorders responsible for this type of hypoglycemia has been increasing due to the recent discoveries in the molecular and biochemical regulation of insulin secretion. In this article, we review the current knowledge of the pathophysiology, clinical presentation, and diagnosis of disorders that cause hyperinsulinemic hypoglycemia of infancy. We highlight the distinction between the diffuse and focal forms of the disease, especially the promising results with (18)F-L-dopa positive emission tomography (PET) scanning for preoperative localization and distinction to guide the extent of surgical removal of pancreatic tissue that may result in cure rather than persistence of disturbed carbohydrate metabolism.
Despite all these discoveries, much remains to be learned, as currently about one third of infants with hyperinsulinemic hypoglycemia have no identifiable cause.
高胰岛素血症性低血糖是成人、儿童和婴儿持续性低血糖最常见的原因。由于最近在胰岛素分泌的分子和生化调节方面的发现，我们对导致这类低血糖的疾病的认识不断增加。在本文中，我们回顾了导致婴儿高胰岛素血症性低血糖的疾病的病理生理学、临床表现和诊断方面的当前知识。我们强调了该疾病弥漫性和局灶性形式之间的区别，尤其是（18）F - L - 多巴正电子发射断层扫描（PET）扫描在术前定位和区分方面取得的有前景的结果，以指导胰腺组织手术切除的范围，这可能导致治愈而非碳水化合物代谢紊乱的持续存在。
尽管有所有这些发现，但仍有许多有待了解，因为目前约三分之一的高胰岛素血症性低血糖婴儿没有可识别的病因。
