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Positron emission tomography in congenital hyperinsulinism
N B Mathur1, Mahesh Sharma, Anil Agarwal
1Department of Pediatrics, Maulana Azad Medical College, New Delhi 110002, India. drnbmathur@vsnl.com
Indian Pediatrics
|March 8, 2011
Summary
Congenital hyperinsulinism was diagnosed in an infant using [18-F]-L-DOPA positron emission tomography (PET). This imaging technique helped guide a successful pancreatectomy, resolving hypoglycemia.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Pediatric Surgery
Background:
- Congenital hyperinsulinism (CHI) is a rare disorder characterized by excessive insulin secretion leading to persistent hypoglycemia.
- Accurate preoperative localization of pancreatic abnormalities is crucial for effective surgical management of CHI.
Observation:
- A neonate presented with recurrent hypoglycemia and laboratory findings indicative of hyperinsulinism (elevated insulin:glucose ratio).
- Diffuse pancreatic abnormality was identified preoperatively using [18-F]-L-DOPA positron emission tomography (PET) imaging.
Findings:
- [18-F]-L-DOPA PET scan successfully visualized diffuse pancreatic involvement in the infant with congenital hyperinsulinism.
- A subtotal (95%) pancreatectomy was performed based on the imaging findings.
- The infant achieved sustained euglycemia post-surgery and was discharged on breast milk.
Implications:
- [18-F]-L-DOPA PET is a valuable tool for preoperative diagnosis and localization in congenital hyperinsulinism.
- Precise imaging can guide surgical extent, potentially improving outcomes and reducing complications.
- This case highlights the successful application of advanced nuclear imaging in managing complex pediatric endocrine disorders.
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