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Islet-Cell Adenoma as a Cause of Juvenile Hyperinsulinism in a Four-Year-Old Boy Report of a Case

David H. Watkins, MD; Frank A. Traylor, MD
JAMA. 1963;185(2):139-142. doi:10.1001/jama.1963.03060020099038.
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HYPOGLYCEMIC CRISES with prominent neuropsychiatric manifestations, terminated by administration of glucose, usually suggest in the adult a pancreatic origin of the symptoms—the Whipple triad. However, in the young child, the same syndrome ordinarily suggests a different cause, since functioning pancreatic islet-cell adenomas are very uncommon in the pediatric age group.1-3

This, the 28th reported case of a functioning islet-cell adenoma in childhood, is presented for three reasons: the rarity of functioning islet-cell adenomas in childhood; the occasional difficulty in establishing a diagnosis in childhood; and to emphasize the constant risk of death from hypoglycemic coma and development of irreversible hypoglycemic encephalopathy.

Report of a Case  A 4-year-old boy was admitted to the Denver General Hospital on Feb 20, 1961, with the chief complaint of convulsions. He had had his first convulsion on Dec 17, 1960, in the morning, immediately after awakening. This generalized convulsion lasted 2 to 3 min


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