<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462025000400007</article-id>
<article-id pub-id-type="doi">10.24875/bmhim.24000102</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hipoglucemia hiperinsulinémica persistente de la infancia en pacientes atendidos en el Hospital Infantil de Especialidades de Chihuahua]]></article-title>
<article-title xml:lang="en"><![CDATA[Persistent hyperinsulinemic hypoglycemia of infancy treated at the Hospital Infantil de Especialidades de Chihuahua]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peña-Varela]]></surname>
<given-names><![CDATA[Claudia E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salazar-Flores]]></surname>
<given-names><![CDATA[Nancy L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramos-Porras]]></surname>
<given-names><![CDATA[Reyna G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Cervantes]]></surname>
<given-names><![CDATA[Karina A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Avena-Portillo]]></surname>
<given-names><![CDATA[Lilia T.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gámez-González]]></surname>
<given-names><![CDATA[Luisa B.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma de Chihuahua Facultad de Medicina y Ciencias Biomédicas ]]></institution>
<addr-line><![CDATA[Chihuahua ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de Especialidades del Estado de Chihuahua Departamento de Pediatría ]]></institution>
<addr-line><![CDATA[Chihuahua ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Infantil de Especialidades del Estado de Chihuahua Departamento de Endocrinología ]]></institution>
<addr-line><![CDATA[Chihuahua ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Infantil de Especialidades del Estado de Chihuahua Departamento de Inmunología ]]></institution>
<addr-line><![CDATA[Chihuahua ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<volume>82</volume>
<numero>4</numero>
<fpage>258</fpage>
<lpage>262</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462025000400007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462025000400007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462025000400007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: La hipoglucemia hiperinsulinémica persistente de la infancia (HHPI) afecta al 0.5-5% de los pacientes pediátricos. Esta condición se debe a una disfunción de las células &#946; del páncreas, lo que provoca tumores e hiperinsulinismo, causando hipoglucemias persistentes. Estas hipoglucemias suelen ser resistentes al tratamiento convencional y requieren intervenciones para reducir la producción de insulina y aumentar los niveles de glucosa, restaurando así el equilibrio metabólico.  Casos clínicos: Se describen tres casos de HHPI. El primero es un paciente rarámuri de cuatro días con hipoglucemias persistentes, diagnosticado tras una pancreatectomía y biopsia. El segundo caso es un paciente de tres días, también de etnia rarámuri, con hipoglucemias persistentes y una lesión pancreática detectada por gammagrafía, confirmándose el diagnóstico de HHPI tras la pancreatectomía. El tercer caso es una paciente de tres días con hipoactividad e hipoglucemias persistentes, quien también fue diagnosticada con HHPI después de una pancreatectomía.  Conclusiones: Aunque la presentación clínica y los resultados bioquímicos generan una alta sospecha diagnóstica, es fundamental la confirmación histopatológica. Un diagnóstico temprano es clave para prevenir secuelas a largo plazo. La HHPI debe considerarse dentro del diagnóstico diferencial de hipoglucemias hiperinsulinémicas en casos como prematurez, restricción del crecimiento intrauterino, bajo peso al nacer, diabetes materna, tirosinemia tipo 1 o síndrome de Beckwith-Wiedemann. Estos casos destacan la complejidad de la HHPI y su presentación inusual en la etnia rarámuri, subrayando la importancia de una atención médica culturalmente sensible.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) affects between 0.5% and 5% of pediatric patients. This condition is caused by a dysfunction of pancreatic &#946;-cells, leading to tumors and hyperinsulinism, which result in persistent hypoglycemia. These episodes are often resistant to conventional treatment and require interventions to reduce insulin production and increase glucose levels, thereby restoring metabolic balance.  Clinical cases: We present three cases of PHHI. The first is a four-day-old Rarámuri patient with persistent hypoglycemia, diagnosed after a pancreatectomy and biopsy. The second case is a three-day-old Rarámuri patient with persistent hypoglycemia and a pancreatic lesion detected by scintigraphy, with PHHI confirmed after pancreatectomy. The third case is a three-day-old female patient with hypoactivity and persistent hypoglycemia, who was also diagnosed with PHHI after a pancreatectomy.  Conclusions: While clinical presentation and biochemical findings raise high diagnostic suspicion, histopathological confirmation is essential. Early diagnosis is key to preventing long-term sequelae. PHHI should be considered in the differential diagnosis of hyperinsulinemic hypoglycemia, such as prematurity, intrauterine growth restriction, low birth weight, maternal diabetes, tyrosinemia type 1, or Beckwith-Wiedemann syndrome. These cases highlight the complexity of PHHI and its unusual presentation in the Rarámuri ethnic group, underscoring the importance of culturally sensitive medical care.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Nesidioblastosis]]></kwd>
<kwd lng="es"><![CDATA[Pediatría]]></kwd>
<kwd lng="es"><![CDATA[Hipoglucemia]]></kwd>
<kwd lng="es"><![CDATA[Hiperinsulinismo]]></kwd>
<kwd lng="es"><![CDATA[Reporte de caso]]></kwd>
<kwd lng="en"><![CDATA[Nesidioblastosis]]></kwd>
<kwd lng="en"><![CDATA[Pediatrics]]></kwd>
<kwd lng="en"><![CDATA[Hypoglycemia]]></kwd>
<kwd lng="en"><![CDATA[Hyperinsulinism]]></kwd>
<kwd lng="en"><![CDATA[Case report]]></kwd>
</kwd-group>
</article-meta>
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