PEDIATRICS Vol. 90 No. 2 August 1992, pp. 212-215
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Palliative Treatment of Hyperinsulinism With Cyproheptadine and Diazoxide

Deborah Rotenstein MD1, Scott Serbin MD1, and Terra Welsh RN, BSN1

1 From the Department of Pediatrics, Medical College of Pennsylvania, Allegheny Campus, Allegheny General Hospital, Pittsburgh

Treatment for hyperinsulinism in infants and children can be difficult and has included numerous treatment modalities. This paper reports 16 months of palliative treatment with cyproheptadine and diazoxide in a child with hyperinsulinism initially diagnosed at 6 months of age (her insulin level was 80 µU/mL while her glucose level was 38 mg/dL). She continued to have episodes of staring and alteration in level of consciousness while receiving her usual doses of diazoxide (12 mg/kg) alone. Mean nocturnal glucose values, which were quite low during treatment with diazoxide alone, improved significantly with the addition of cyproheptadine to her therapeutic regimen. Fasted C-peptide values, elevated during diazoxide alone, returned to the normal range with combination treatment for 16 months. Cyproheptadine and diazoxide in combination may be useful for treatment of hyperinsulinism that presents after the neonatal period.

Key Words: hyperinsulinism • hypoglycemia • nesidioblastosis

Submitted on September 20, 1991
Accepted on January 15, 1992




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