skip to main content

Hyperinsulinism — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardEndocrinologyHyperinsulinismRACP Paediatrics

A 5-year-old boy presents with episodic hypoglycaemia. During a hypoglycaemic episode (blood glucose 1.8 mmol/L), serum insulin is 25 mU/L (inappropriately elevated), C-peptide is elevated, and ketones are low. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Insulinoma or congenital hyperinsulinism

Hyperinsulinaemic hypoglycaemia is characterised by low blood glucose with inappropriately elevated insulin and C-peptide, suppressed ketones and free fatty acids, and high glucose requirements. In a 5-year-old, an insulinoma should be considered (though rare in children). Congenital hyperinsulinism typically presents in infancy. Imaging (CT/MRI pancreas, ¹⁸F-DOPA PET) and genetic testing are indicated.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Hypoglycaemia