Diagnosis And Management Of Congenitical Hyperinsulinism In Neonate Term A Retrospective Review Of 5 Cases

Objective:To investigate the early diagnosis and treatment of congenital hyperinsulinism.Methods:Retrospectively analyzing 5 cases of congenital hyperinsulinism in neonate term who were treatmented in our ward during 1995-2007 year.Results:The main symptoms included convulsion,apnea,feeling hunger,sweeting and irritability in neonate.The laboratory examination included persistent hypoglycemia and hyperinsulinism,INS/blood glucose was more than 0.3,urine acetone bodies was negative,glucagons test was positive.The histologic lesion of one case was nesidioblastosis.1case had 95%subtotal pancreatectomy.Blood glucose and blood insulin returned to normal range after operation.1 case was treatmented with diazoxide,but the concentration of blood glucose was often less than 2.2mmol/L.During follow-up,3 cases recovered,but 2 cases had subsequent epilepsy,and 2 cases was failed to contact,another case died from sever pneumonia.Conclusion:To have to detect blood glucose when newborn infant was convulsive.Blood glucose,blood insulin and urine ketones examinations are helpful in early diagnosis of congenital hyperinsulinism.95%subtotal pancreatectomy is effective.Howere,diazoxide is ineffective.