Preoperative use of octreotide in a newborn with persistent hyperinsulinemic hypoglycemia of infancy

In this paper, we describe a newborn diagnosed with persistent hyperinsulinemic hypoglycemia of infancy (PHHI) at two days of age. She presented with severe asymptomatic hypoglycemia and required both a high rate of glucose infusion and diazoxide treatment. On the 9th hospital day, due to persistent and intractable hypoglycemia, subcutaneous octreotide treatment was initiated. This treatment reduced the rate and concentration of glucose needed to be infused but the hypoglycemia did not subside totally. On the 18th hospital day near-total pancreatectomy was performed. Tachyphylaxis resulting from continuous use of octreotide limited its effect but enabled us to keep the patient euglycemic preoperatively.