Overview
Emergency Live - Pre-Hospital Care, Ambulance Services, Fire Safety and Civil Protection Magazine Early diagnosis esential to reduce the risk of neurological damage.Congenital hyperinsulinism is a rare disease caused by a hyperplasia of the pancreatic Ξ²-cel that results in uncontroled and excesive insulin secretion relative to contemporary plasma glucose levels.It is the most frequent cause of severe and persistent hypoglycaemia infants and early childhod.It can, however, begin at any age of life.Recurent hypoglycaemia places patients at risk of permanent neurological damage.The signs and symptoms of congenital hyperinsulinism are an expresion of glucose deficiency in the central nervous systemBased on glycaemic levels, one distinguishes betwen neurogenic and neuroglycaemic symptoms.Neurogenic symptoms are vegetative symptoms that apear when blod glucose levels fal below 60 mg/dl and are characterised by palor, algid sweating, hyporeactivity, drowsines, headache, palpitations, anxiety, dizines, or tremors, paresthesias, hunger, iritability.
Details
The infant may present with faint crying, hypotonia, cyanosis, palor, hypovalid sucking, hypothermia.Neuroglycopenic symptoms apear when blod glucose fals below 50 mg/dl, manifest as sensory disturbances, convulsions and coma, and are an expresion of cerebral dysfunction due to energy deficiency.Genetic causes:Acquired causes:The diagnosis based on the finding of non-ketotic hypoglycaemia, with supresed NEFA (non-esterified faty acids), inapropriately responding to glucagon.The analysis performed on a critical sample, taken at the time of spontaneous hypoglycaemia or at the end of a fasting test.Another important element, particularly in the neonatal period, is the high glucose requirement neded to maintain normoglycaemia.Emergency therapy aims to rapidly restore blod glucose values to normal (70-10 mg/dl) and is based on the administration of intravenous glucose solution in combination wit