Portosystemic shunt as a cause of congenital hyperinsulinemic hypoglycemia
Portosystemic shunt as a cause of congenital hyperinsulinemic hypoglycemia
复制标题
门体分流是先天性高胰岛素性低血糖的原因
作者：
Keisuke Yoshii;M. Noda;Y. Naiki;R. Horikawa
先天性高胰岛素血症性低血糖症（CHH）的特征是在存在低血糖症的情况下胰腺β细胞不适当地分泌胰岛素。我们在此描述了一例5个月大的男孩因先天性门体分流（CPSS）而患CHH的病例。胰腺β细胞分泌的胰岛素流入门静脉，首先在肝脏代谢。胰岛素在肝脏中的首过消除导致人体胰岛素浓度大幅降低约40-80%。由于缺乏肝脏首过消除，CPSS将大量胰岛素输送到体循环中。低血糖可由达到正常葡萄糖水平后持续高水平的胰岛素引起。因此，应将CPSS视为CHH的罕见原因，尤其是在餐后高胰岛素血症性低血糖的情况下。
Congenital hyperinsulinemic hypoglycemia (CHH) is characterized by the inappropriate secretion of insulin from pancreatic beta cells in the presence of hypoglycemia. We herein describe the case of a 5‐month‐old boy with CHH due to congenital portosystemic shunt (CPSS). Insulin secreted from pancreatic beta cells flows into the portal vein and is first metabolized in the liver. First‐pass elimination of insulin in the liver leads to great decrease in insulin concentration by approximately 40–80% in humans. CPSS accounts for a large quantity of insulin delivery into the systemic circulation due to the lack of hepatic first‐pass elimination. Hypoglycemia can result from consistently high levels of insulin after reaching normal glucose level. CPSS therefore should be considered as a rare cause of CHH, especially in the case of post‐prandial hyperinsulinemic hypoglycemia.
影响因子：
5.8
作者：
Stanley, Charles A.
通讯作者：
Stanley, Charles A.
影响因子：
7.7
作者：
Meier, JJ;Veldhuis, JD;Butler, PC
通讯作者：
Butler, PC