Pancreas Pathology in Hyperinsulinemia Hypoglycemia of Infancy

Hyperinsulinism is responsible for about 55% of hypoglycemia in children less than 1 year old. In this study pancreas from 8 children with idiopathic hyperinsulinemic hypoglycemia of infancy(HHI) who underwent pancreatectomy in Ali-Asghar Hospital from 10 years ago were examined, using histochemical method and morphometric measurements. The children ranged from 3 to 13 months, and were presented with seizure. They all had positive glucagon test and high serum ins/glu ratio and were unresponsive to medical therapy(Diazoxide, Somatostatin or Hidrocortisone). Sections were studied with particular reference to islet cell distribution in patients and controls. Quantitative assessments were made of islet size and total surface area of pancreas occupied by endocrine tissue. Four patients had diffuse islet cell hyperplasia and others showed multifocal islet cell hyperplasia, islet cell dysplasia, adenoma and normal pancreas, respectively. Immunostaining can show any recapitulation of islet structure or increase of B cells. Furthermore, frozen section study during surgery can help to distinguish different pathologies of HHI.