| Autor: |
Baker, L, Winegrad, A I, Vallet, H L, Clements, R S, Morrow, G, Bongiovanni, A M |
| Zdroj: |
Pediatric Research; August 1971, Vol. 5 Issue: 8 p396-397, 2p |
| Abstrakt: |
A 9½ year old girl has had severe reactive hypoglycemia since age 11 months. No evidence of a pancreatic adenoma was found on Iaparotomy. On recent re-evaluation, abnormalities of CHO metabolism were documented in bothe the fed and fasting states. Oral GTT consistently demonstrtes a slightly elevated fasting level, a 2 hour value in excess of 140 mg.%, and a 5 hour value less than 40 mg.%. Plasma insulin concentration peaked at 1½ to 3 hours (50–50 µU/ml) but are still elevated at the 5th hour. This pattern was unaltered by therapy with Diazoxide or Tolbutamide. Symptomatic hypoglycemia consistently develops on prolonged fasting (20–24 hours). The plasma FFA, ketone and amino acids fail to show an appropriate response to fasting. Fasting hypoglycemia is rapidly corrected by the administration of glycerol, a substrate for gluconeogenesis. Despite normal growth, plasma HGH was undetectable following spontaneous hypoglycemia or exercise, or during sleep. Maximal stimulation with sequential insulin-arginine tolerance tests gave a subnormal respone (5 mµg/ml). Acute HGH therapy prevented fasting hypoglycemia, and plasma FFA and ketones rose appropriately. Reactive hypoglycemia was also corrected. This appears to be a new hypoglycemic syndrome. |
| Databáze: |
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| Externí odkaz: |
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