胰岛素瘤是儿童低血糖的罕见病因:1例报告

R. Pereira, Alessandra Cavalcante, Nancy Linhares, Milena Sousa, L. Aragão, A. Carvalho, A. Montenegro
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摘要

简介:胰岛素瘤是一种起源于胰腺β细胞的神经内分泌肿瘤,可导致严重和频繁的餐前低血糖。诊断应考虑惠普尔三联征(出现在75%的病例中)的存在,并通过证明高胰岛素水平与低血糖水平相关联来确诊。治疗方法是手术,在大多数情况下是可以治愈的。病例报告:女孩,10岁,住院调查可能的难治性癫痫,主要是早晨癫痫发作,在入院前6个月开始。由于癫痫发作期间出现低血糖,静脉输注葡萄糖后有所改善,因此要求进行儿科内分泌学评估。在关键样本的测试中,发现高胰岛素血症与低血糖相关。因此,在影像学检查显示胰腺内病变后,考虑并确认了胰岛素瘤的诊断。她转介手术切除,肿瘤去核后进展良好。评论:胰岛素瘤是一种罕见的小儿神经内分泌肿瘤。它最初可能表现为难以控制的抽搐状态,伴有行为改变和发育迟缓,这经常导致误诊。因此,早期诊断和干预很重要,因为它们可以降低受影响个体的发病率和死亡率。患者未出现神经系统后遗症,术后进展良好,无症状复发或进一步高血糖发作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Insulinoma as a rare cause of hypoglycemia in childhood: case report
INTRODUCTION: Insulinoma is a neuroendocrine tumor that originates in pancreatic beta cells, resulting in severe and frequent preprandial hypoglycemia. The diagnosis should be considered in the presence of the Whipple triad (present in 75% of cases) and confirmed through the demonstration of high insulin levels associated with low serum glucose levels. Treatment is surgical and, in most cases, curative. CASE REPORT: Girl, 10-years-old, hospitalized for the investigation of possible refractory epilepsy with predominant morning seizures, which started 6 months prior to her admission. A pediatric endocrinology evaluation was requested, as hypoglycemia was evidenced during the occurrence of seizures, which improved after intravenous glucose infusion. During the tests of the critical sample, hyperinsulinism associated with hypoglycemia was revealed. The diagnosis of insulinoma was therefore considered and then confirmed, after an intrapancreatic lesion showed up on the imaging tests. She was referred for surgical excision and had good evolution after tumor enucleation. COMMENTS: Insulinoma is a rare neuroendocrine tumor in the pediatric group. It may initially present itself as a hard-to-control convulsive condition, accompanied by behavioral changes and developmental delay, which often leads to misdiagnosis. Thus, early diagnosis and intervention are important since they reduce the morbidity and mortality of affected individuals. The patient did not present neurological sequelae and had a favorable post-surgical evolution, without recurrence of symptoms or further episodes of hyperglycemia.
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