Hypoglycemia with an inability toincrease the epinephrine secretion in insulin-induced hypoglycemia

• Published in: The Journal of pediatrics Vol. 59; no. 2; pp. 215 - 222
• Main Authors: Broberger, Ove, Zetterström, Rolf
• Format: Journal Article
• Language: English
• Published: Mosby, Inc 01.08.1961
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(61)80082-6

Clinical data of 7 children, suffering fromhypoglycemia with an inability to increase the epinephrine secretion in insulin-induced hypoglycemia, are presented. All children showed an increased sensitivity to insulin. Whereas the epinephrine secretion increases five- to twentyfold in normal children and in children with hypoglycemia of other origin, an increase of the epinephrine secretion was absent or very slight in the patients studied. A study of the carbohydrate metabolism revealed no other signs of abnormality. Almost all children had a low birth weight, well below the normal range for the gestational age. A diagnosis of hypogycemia was, as a rule, established rather late, but symptoms indicative of a hypoglycemia disorder, repeated attacks of unconsciousness, and convulsions were present during the early neonatal period in some of the children. In one of the patients the disease started during the course of serous meningitis and the possibility of the hypoglycemia being caused by a defective central stimulation of the adrenal medulla is discussed. Four of the children received treatmentwith ephedrine in a daily dose of 10 mg. Three of these children have not had any further hypoglycemic attacks. The incidence of hypoglycemia of thisparticular type among all cases of hypoglycemia, seen at the Pediatric Clinic of the University of Gothenburg, was found to be rather high, amounting to about 50 per cent of all cases of hypoglycemia.