Transient hepatomegaly and excessive plasma insulin levels can be helpful signs in diagnosing malicious insulin overdose in children presenting with severe hypoglycemia.
May support plasma insulin testing in recurrent pediatric hypoglycemia; hypothesis-generating and requires prospective validation.
On two occasions, a 3 1/2-year-old black girl had severe hypoglycemia associated with transient hepatomegaly. The plasma insulin level during the second hypoglycemic episode was excessive and led to a diagnosis of malicious insulin administration. We suggest that plasma be obtained for insulin determination in children with hypoglycemia, and that transient hepatomegaly may be a helpful sign in cases of insulin overdose.
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Robert A. Dershewitz (1976) studied this question.
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