Cited by 239Pancreatic function and diabetesDiabetes and associated disordersMetabolism and Genetic Disorders

The DOI matches its Crossref record; 102 of the 104 references it cites were found in a registry or an index.

Perspective on the Genetics and Diagnosis of Congenital Hyperinsulinism Disorders

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Stanley, Charles A.·2016·The Journal of Clinical Endocrinology & Metabolism

Abstract

CONTEXT: Congenital hyperinsulinism (HI) is the most common cause of hypoglycemia in children. The risk of permanent brain injury in infants with HI continues to be as high as 25-50% due to delays in diagnosis and inadequate treatment. Congenital HI has been described since the birth of the JCEM under various terms, including "idiopathic hypoglycemia of infancy," "leucine-sensitive hypoglycemia," or "nesidioblastosis." EVIDENCE ACQUISITION: In the past 20 years, it has become apparent that HI is caused by genetic defects in the pathways that regulate pancreatic β-cell insulin secretion. EVIDENCE SYNTHESIS: There are now 11 genes associated with monogenic forms of HI (ABCC8, KCNJ11, GLUD1, GCK, HADH1, UCP2, MCT1, HNF4A, HNF1A, HK1, PGM1), as well as several syndromic genetic forms of HI (eg, Beckwith-Wiedemann, Kabuki, and Turner syndromes). HI is also the cause of hypoglycemia in transitional neonatal hypoglycemia and in persistent hypoglycemia in various groups of high-risk neonates (such as birth asphyxia, small for gestational age birthweight, infant of diabetic mother). Management of HI is one of the most difficult problems faced by pediatric endocrinologists and frequently requires difficult choices, such as near-total pancreatectomy and/or highly intensive care with continuous tube feedings. For 50 years, diazoxide, a KATP channel agonist, has been the primary drug for infants with HI; however, it is ineffective in most cases with mutations of ABCC8 or KCNJ11, which constitute the majority of infants with monogenic HI. CONCLUSIONS: Genetic mutation testing has become standard of care for infants with HI and has proven to be useful not only in projecting prognosis and family counseling, but also in diagnosing infants with surgically curable focal HI lesions. (18)F-fluoro-L-dihydroxyphenylalanine ((18)F-DOPA) PET scans have been found to be highly accurate for localizing such focal lesions preoperatively. New drugs under investigation provide hope for improving the outcomes of children with HI.

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  1. Hartmann AF, Jaudon JC. Hypoglycemia. J Pediatr. 1937;11:1-36.
  2. Yakovac WC, Baker L, Hummeler K. ␤ Cell nesidioblastosis in id- iopathic hypoglycemia of infancy. J Pediatr. 1971;79:226 -231.
  3. Suchi M, Thornton PS, Adzick NS, et al. Congenital hyperinsulin- ism: intraoperative biopsy interpretation can direct the extent of pancreatectomy. Am J Surg Pathol. 2004;28:1326 -1335.
  4. Meissner T, Otonkoski T, Feneberg R, et al. Exercise induced hy- poglycaemic hyperinsulinism. Arch Dis Child. 2001;84:254 -257.

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Metadata

Authors
Stanley, C. A.
Affiliations
Children's Hospital of Philadelphia (US)
Corresponding author
Stanley, Charles A.
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2016-03
Volume
101
Issue
3
Pages
815-826
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2277559429
Cited by
239
References
104
Citations by year
2026: 14 · 2025: 13 · 2024: 13 · 2023: 13 · 2022: 24 · 2021: 25 · 2020: 36 · 2019: 24 · 2018: 39 · 2017: 25 · 2016: 13
FWCI
6.67
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Children's Hospital of Philadelphia
  • National Institutes of Health
  • National Institute of Diabetes and Digestive and Kidney Diseases (R37DK056268)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
Keywords
congenital hyperinsulinism, pancreatic beta-cell insulin secretion, ABCC8, KCNJ11, genetic diagnosis, diazoxide, near-total pancreatectomy, 18F-DOPA PET, focal pancreatic lesions, Beckwith-Wiedemann syndrome, Kabuki syndrome, Turner syndrome, neonatal hypoglycemia
MeSH terms
Insulin Secretion, Humans, Infant, Newborn, Insulin, Congenital Hyperinsulinism, KATP Channels

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