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Hepatomegaly due to self-induced hyperinsulinism
Archives of Disease in Childhood
|February 1, 1979
Summary
Hypoglycaemic attacks and transient hepatomegaly in a diabetic girl ceased with insulin withdrawal and resumed upon its reintroduction. The condition resolved only after stopping surreptitious insulin use, highlighting overdosage as a cause.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Mellitus Management
Background:
- Insulin-dependent diabetes mellitus requires careful dosage management.
- Hypoglycaemia and hepatomegaly are potential complications in diabetic patients.
- Transient hepatomegaly can present as an unusual symptom in pediatric diabetes.
Observation:
- A 12-year-old girl experienced recurrent hypoglycaemic attacks with transient hepatomegaly.
- Symptoms persisted despite insulin dose reduction and complete discontinuation.
- Attacks ceased during hospitalization, requiring insulin reintroduction.
Findings:
- The patient's hepatomegaly resolved upon identification and cessation of surreptitious additional insulin injections.
- This case suggests a link between excessive insulin administration and transient hepatomegaly.
- The clinical presentation mimicked other conditions but was ultimately attributed to insulin overdosage.
Implications:
- Hepatomegaly in diabetic patients warrants suspicion of insulin overdosage.
- This case underscores the importance of considering non-adherence or external factors in treatment failures.
- Enhanced monitoring and patient/family education are crucial in managing pediatric diabetes to prevent such events.