Abstract
Clinical features of “ketotic hypoglycemia” and of idiopathic hypoglycemia of the ZETTERSTROM-type are almost identical. The question is, whether or not this two “types” of hypoglycemia can be separated from each other. In 7 infants, suffering from spontaneous hypoglycemic attacks, both a ketogenic diet and a quantitation of urinary epinephrine (EPI) during an insulin tolerance test (ITT) were performed. Hyperinsulinism was excluded by a normal tolbutamid test in all 7 infants. During the ketogenic diet 5 of the 7 infants exhibited a critical drop in plasma glucose (below25 mg%). The rise of EPI during ITT was absent or lowered in 4 of these 5 infants. In the 2 infants without critical drop in plasma glucose during a ketogenic diet the reaction of the adrenal medulla was controversial: the rise of EPI was absent in one child and very high in the other.
The data suggest, that “ketotic hypoglycemia” and thehypoglycemia with reduced epinephrine response to fall of plasma glucose are not two different types of infantile hypoglycemia, since many patients fullfill the criteria of both “types” of hypoglycemia.
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Tietze, H., Grossman, D. ARE THE “KETOTIC HYPOGLYCEMIA” AND THE IDIOPATHIC HYPOGLYCEMIA ASSOCIATED WITH IMPAIRED EPINEPHRINE RELEASE (ZETTERSROM) THE SAME DISEASE?. Pediatr Res 9, 690 (1975). https://doi.org/10.1203/00006450-197508000-00140
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DOI: https://doi.org/10.1203/00006450-197508000-00140