二例GCK基因突变致先天性高胰岛素性低血糖症的诊疗和基因检测分析

Diagnosis,treatment and genetic analysis of two cases of congenital hyperinsulinemic hypoglycemia caused by GCK gene mutation

先天性高胰岛素血症(congenital hyperinsulinemia,CHI)是一组由胰腺β细胞不适当分泌胰岛素引起持续低血糖的异质性疾病。迄今发现15种基因突变与CHI相关。编码葡萄糖激酶(glucokinase,GCK)基因突变引起的葡萄糖激酶型高胰岛素血症(GCK-CHI)为CHI的罕见类型。本文主要报道了收集到的2例GCK-CHI患者的临床资料和基因检测结果。通过总结2例患者的病例特点及其基因检测分析发现,对于临床上反复发作持续性低血糖的患者要考虑CHI。在这部分患者当中进行基因检测有助于避免误诊,提供治疗策略,改善预后。

Congenital hyperinsulinemia(CHI)is a heterogeneous disorder characterized by persistent hypoglycemia due to inappropriate insulin secretion.A total of 15 gene mutations have already been reported to be associated with CHI.Among them,CHI caused by the GCK mutation is named GCK-CHI,which is considered to be a rare form of CHI.Here,we reported two cases of GCK-CHI diagnosed by genetic testing and summarized the clinical characteristics.In patients with recurrent or persistent hypoglycemia,CHI should be taken into consideration.Genetic testing should be perfomed in these patients to avoid misdiagnosis and provide accurate intervention,thus to improve prognosis.