Treating CHI

Systematic treatment aims to prevent irreversible damage to the brain. Intensive medical procedures include continual central venous glucose intake (> 8-25mg/kg*min) and glucagon infusions in order to release the body┬┤s own glucose reserves. Other available medications are diazoxide (brand name: Proglicem) and somatostatin. A carbohydrate-rich diet suffices in some cases to attain stable blood glucose above 3.0 mmol/l, i.e. 55 mg/dl. Focal form CHI is present in about 40% of affected infants. A lesion confined to an area usually smaller than 1 cm is the cause of the most severe persistent hypoglycemias. The child can be cured permanently if this focus is properly detected and removed.

Success in operating on the focal form depends on good team work between the nuclear medicine specialist/radiologist, pathologists and surgeons. Sonography is also of value for intraoperative tissue differentiation.


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