Eur J Pediatr Surg 2011; 21(3): 188-189
DOI: 10.1055/s-0030-1270455
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© Georg Thieme Verlag KG Stuttgart · New York

Is Octreotide Safe for the Management of Persistent Hyperinsulinemic Hypoglycemia of Infancy?

M. Abdel Khalek1 , E. Kandil2
  • 1Tulane University, School of Medicine, Surgery, New Orleans, United States
  • 2Tulane Health Sciences Center, Surgery, New Orleans, United States
Further Information

Publication History

Publication Date:
31 January 2011 (online)


Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is a glucose metabolic disorder characterized by profound hypoglycemia and inappropriate insulin secretion. It is also known as nesidioblastosis [1].

Neonates with PHHI run a high risk of severe neurological damage secondary to severe hypoglycemia unless immediate steps are taken to provide adequate management [2]. Management should include high glucose infusion and medical treatment with diazoxide and octreotide (somatostatin analogue). Pancreatectomy or resection of the focal lesion has to be performed as soon as possible, particularly in cases where medical treatment is not successful [3].

Octreotide is a synthetic analog of the hypothalamic release-inhibiting hormone Somatostatin [4]. The drug is licensed to treat bleeding from esophageal varices, to provide relief of symptoms in patients with neuroendocrine tumors, a reduction of complications following pancreatic surgery, and a reduction of vomiting in palliative care. It has been reported to be effective in treating chyle-rich effusions in children following cardiac surgery [5] [6]. Its beneficial effects in PHHI have been attributed to the inhibition of insulin release mediated through calcium channel inhibition [7].

Use of somatostatin and its analogs has recently been introduced into the management of PHHI. However, this relatively new treatment may have side effects and contraindications. We describe an association in a neonate treated with a somatostatin analog (octreotide) with subsequent necrotizing enterocolitis.


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Dr. Emad Kandil

Tulane Health Sciences Center


New Orleans

United States