A hypoglycaemic ‘Peter Pan’: a paediatric disease in an adult patient?
Year: 2025
Type: article
Study design: Case Report
Abstract: Summary: A 56-year-old male presented to hospital with vomiting and was admitted for management of suspected aspiration pneumonia. His medical history was significant for a diagnosis of cerebral palsy and intellectual disability and he had suffered regular generalised tonic-clonic seizures (GTCS) since birth, despite multimodal anticonvulsant treatment. During his admission, his capillary blood glucose was noted to be 1.6 mmol/L during a seizure. Subsequent investigations confirmed hyperinsulinaemic hypoglycaemia secondary to diffuse pancreatic nesidioblastosis. His seizure disorder completely resolved when management of nesidioblastosis achieved consistent normoglycaemia. Learning points: All patients who suffer seizure should have a blood glucose measured. Unrecognised hypoglycaemia in a neonate or infant confers a high risk of subsequent neurological damage. Persistent hyperinsulinaemic hypoglycaemia (PHH) in adults is highly likely to be caused by insulinoma, but diffuse pancreatic hyperinsulinism, particularly after bariatric surgery, should also be considered. Medical therapy of endogenous hyperinsulinaemic hypoglycaemia is complex, requiring intensive monitoring.
DOI: 10.1530/edm-23-0140
Authors: Shannon McCarthy, Mark Kotowicz
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $612
OpenAlex ID: W4411151376