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Severe organic hyperinsulinism in infants results in a high mortality rate with a frequent incidence of permanent cerebral damage. A case of severe hyperinsulinism in a 3-week-old child, controlled only by intravenous glucose, is presented. Symptoms necessitated an 80 percent pancreatectomy at 10 weeks of age. Recurrent symptoms, with increasing cerebral damage, prompted a total pancreatectomy at age 5 months. The child has done well, cerebral damage has been reversed, and she is apparently normal at 15 months of age except for the induced diabetes which has been a minor problem. A plea is made for earlier surgical treatment in severe infant hyperinsulinism.
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