[Persistent hyperinsulinemic hypoglycemia. Two case reports]. / Hipoglucemia hiperinsulinémica persistente. Informe de dos casos.

We report two cases of infants who presented seizures and persistent hypoglycemia. In both infants, we established diagnosis of persistent hypoglycemia by hyperinsulinism (PHH); glycemic/insulinic ratio was > 0.3, and we found no pancreatic changes by means of other diagnostic procedures. The medical treatment consisted of hydrocortisone, diazoxide, and octreotide without response. Definitive treatment made was sub-total pancreatectomy; postoperatory evolution was satisfactory, and the histologic report showed changes in Langerhans islet of nesidioblastosis. We conclude that PHH and glucose/insulin ratio > 0.3 indicates that surgical treatment with pancreatectomy should not be delayed.