Hyperinsulinemic Hypoglycemia of the Neonate Associated with Persistent Fetal Histology and Function of the Pancreas
Hyperinsulinemic Hypoglycemia of the Neonate Associated with Persistent Fetal Histology and Function of the Pancreas
复制标题
新生儿高胰岛素性低血糖与持续胎儿胰腺组织学和功能相关
DOI：
10.1097/00000658-198002000-00009
复制
发表时间：
1980
影响因子：
9
通讯作者：
J. Haller
中科院分区：
文献类型：
--
作者：
D. Shermeta;G. Mendelsohn;J. Haller
在发育早期，胎儿胰腺的特征在于存在两代不同的内分泌细胞和对循环葡萄糖水平的急性变化无反应的B细胞团。在子宫内发育接近尾声时，正常的胰腺已经“成熟”，并含有单代内分泌细胞和B细胞，这些细胞对葡萄糖浓度的变化有反应。最近对一名患有高胰岛素血症低血糖症的婴儿切除的胰腺组织进行的显微镜检查显示，在这种新生儿疾病中，所有三种目前公认的发现都是结合在一起的：增生、腺瘤病和胰岛母细胞增多症。这些观察结果提示了以下假设：当与发育中胰腺的常规组织学相比时，胰岛母细胞瘤可以解释为内分泌细胞正常增殖的异常延续;增生可能是次级朗格汉斯岛的特定过度生产;腺瘤病可能是初级朗格汉斯岛的异常延续或过度生长。这种外推法表明，婴儿高胰岛素血症性低血糖可能代表胎儿胰腺内分泌部分正常组织学和功能成熟的失败。
Early in development, the fetal pancreas is characterized by the presence of two distinct generations of endocrine cells and a B-Cell mass that is unresponsive to acute changes in circulating glucose levels. Near the end of intrauterine development, the normal pancreas has “matured” and contains a single generation of endocrine cells and B-Cells that are responsive to changes in glucose concentrations. Recent microscopic examination of resected pancreatic tissue from an infant with hyperinsulinemic hypoglycermia revealed a combination of all three of the currently accepted findings in this neonatal condition: hyperplasia, adenomatosis, and nesidioblastosis. These observations prompted the following hypothesis: When compared to the usual histology of the developing pancreas, nesidioblastosis may be interpreted as an abnormal continuation of normal proliferation of endocrine cells; hyperplasia may be a specific overproduction of the Secondary Islands of Langerhans; and adenomatosis may be an abnormal continuation or overgrowth of the Primary Island of Langerhans. Such extrapolation suggests that infants with hyperinsulinemic hypoglycemia may represent a failure in the normal histological and functional maturation of the endocrine portion of the fetal pancreas.