{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:45:38Z","timestamp":1792111538543,"version":"4.4.0"},"reference-count":32,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Congenital hyperinsulinism (CHI) is the most common genetic cause of hypoglycemia in infants. Severe CHI may result from a focal pancreatic lesion (FoCHI), which can be surgically removed, although postoperative complications may occur, particularly after pancreatic head resections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the spontaneous glycemic evolution of FoCHI before surgery and to assess the potential role of conservative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed medical records of patients with FoCHI managed at a single referral center. Congenital hyperinsulinism severity was classified according to the need for continuous gastric tube feeding (TF) to maintain glycemic control prior to surgery, defining a TF group and a no\u2013tube feeding (NTF) group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-nine patients were included: 12 (30.8%) in the NTF group and 27 (69.2%) in the TF group. Patients in the NTF group were diagnosed later (P = .022), had less severe initial hypoglycemia (P = .003), and 4\/12 did not undergo surgery and were cured of hypoglycemia before 6 years of age. We developed an exploratory predictive score for early disease evolution, showing a specificity of 97%. Surgery was curative in most patients (96.3% in the TF group, 100% in the NTF group). Long-term complications were uncommon (8.6% vs 0%) and consisted exclusively of exocrine pancreatic insufficiency, occurring only after pancreatic head surgery (15.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately 30% of infants with FoCHI demonstrated rapid early improvement. While surgery remains the standard curative treatment, a conservative approach may be considered in selected infants with pancreatic head lesions who show early favorable glycemic evolution, potentially after surgical exploration to assess postoperative risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag227","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:49:59Z","timestamp":1781092199000},"page":"3032-3041","source":"Crossref","is-referenced-by-count":0,"title":["Focal congenital hyperinsulinism: spontaneous glycemic improvement before surgery"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-2810","authenticated-orcid":false,"given":"Jean-Baptiste","family":"Arnoux","sequence":"first","affiliation":[{"name":"Reference Centre for Inherited Metabolic Disorders, Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), INSERM-1151, INEM, G2M Network, MetabERN, Paris Cit\u00e9 University , Paris 75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Mayer","sequence":"additional","affiliation":[{"name":"Paediatric Hepatology Department, Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), Paris Cit\u00e9 University , Paris 75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8133-161X","authenticated-orcid":false,"given":"Imen","family":"Jhaouat","sequence":"additional","affiliation":[{"name":"Paediatric Department, Orleans University Hospital , Orl\u00e9ans la Source 45100 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Saint-Martin","sequence":"additional","affiliation":[{"name":"Department of Genetics, La Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP) , Paris 75013 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire-Marine","family":"B\u00e9rat","sequence":"additional","affiliation":[{"name":"Reference Centre for Inherited Metabolic Disorders, Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), INSERM-1151, INEM, G2M Network, MetabERN, Paris Cit\u00e9 University , Paris 75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucile","family":"Altenburger","sequence":"additional","affiliation":[{"name":"Paediatric Department, Nantes University Hospital , Nantes 44000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9528-3546","authenticated-orcid":false,"given":"Ana\u00efs","family":"Brassier","sequence":"additional","affiliation":[{"name":"Reference Centre for Inherited Metabolic Disorders, Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), INSERM-1151, INEM, G2M Network, MetabERN, Paris Cit\u00e9 University , Paris 75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1740-5990","authenticated-orcid":false,"given":"Juliette","family":"Bouchereau","sequence":"additional","affiliation":[{"name":"Reference Centre for Inherited Metabolic Disorders, Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), INSERM-1151, INEM, G2M Network, MetabERN, Paris Cit\u00e9 University , Paris 75015 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0083-566X","authenticated-orcid":false,"given":"Stefania","family":"Querciagrossa","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia, La Timone University Hospital, Assistance Publique-H\u00f4pitaux de Marseille (AP-HM) , Marseille 13005 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Necker-Enfants Malades University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP) , Paris 75015, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrielle","family":"Aveline","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Sorbonne Universit\u00e9, Tenon University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP) , Paris 75020 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Montravers","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Sorbonne Universit\u00e9, Tenon University Hospital, Assistance Publique-H\u00f4pitaux de Paris (AP-HP) , Paris 75020 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-5402","authenticated-orcid":false,"given":"Carmen","family":"Capito","sequence":"additional","affiliation":[{"name":"Department of Pediatric 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