Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis
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Megan Rodrigues
Abstract
Objectives
Describe clinical characteristics, course, and risk factors for hyper-insulinemic hypoglycemia (HIH) in preterm infants and identify impediments to early diagnosis.
Methods
Electronic records of infant–mother dyads were used to describe clinical characteristics, lab parameters, and course of HIH.
Results
All eight patients (gestational ages 26w0d–29w3d) had intrauterine growth restriction (IUGR) due to placental insufficiency, (4/8) were small for gestational age. All maintained normal glucose levels with glucose infusion during the first 48 h six of eight patients had cholestasis despite being on parenteral nutrition for short time (average 17 days). Four of eight patients were treated with diazoxide (average 22 days). Four of eight patients who recovered spontaneously (average 49 days after diagnosis) responded to continuous feeds and hydrocortisone for other clinical indications.
Conclusions
In IUGR preterms, HIH is asymptomatic, may be prolonged, requiring diazoxide treatment. Transient cholestasis is seen in majority of patients. Euglycemia should be demonstrated on bolus gavage feeds, off glucocorticoids before discontinuing blood glucose monitoring.
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Research funding: No outside funding was received for this project.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. All authors participated in the retrieval of the data and take responsibility for its integrity and accuracy. Retrieval and interpretation of maternal data: GL, MR. Concept and design: VP, CM and MN. Analysis, interpretation, and display of the data: all authors. Initial draft of the paper: VP. Critical revision of the paper: VP, CM, MN. Intellectual content: all authors. Supervision: VP.
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Competing interests: Authors state no conflict of interest. The authors declare that they have no competing interests. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of University of Kansas Medical Center, Children’s Mercy Hospital.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The University of Kansas Medical center’s Institutional Review Board approved the study prior to obtaining the data.
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review Article
- Congenital hyperinsulinism: recent updates on molecular mechanisms, diagnosis and management
- Original Articles
- Weight changes of children in 1 year during COVID-19 pandemic
- Three novel mutations of the BCKDHA, BCKDHB and DBT genes in Chinese children with maple syrup urine disease
- Rates of adrenal insufficiency using a monoclonal vs. polyclonal cortisol assay
- Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis
- Identification of three novel pathogenic mutations in cystathionine beta-synthase gene of Pakistani intellectually disabled patients
- The prevalence of incidental finding of gynecomastia on thoracic computed tomography in the pediatric age group
- The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou
- Investigation of androgen receptor gene CAG repeat length polymorphism in pubertal gynecomastia
- A single-centre study of genetic mutations, audiology, echocardiogram and pulmonary function in Saudi children with osteogenesis imperfecta
- A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts
- Clinical, pathological and molecular spectrum of patients with glycogen storage diseases in Pakistan
- Allelic dropout in PAH affecting the results of genetic diagnosis in phenylketonuria
- Short Communication
- Role of the SARS-CoV-2 virus in the appearance of new onset type 1 diabetes mellitus in children in Gran Canaria, Spain
- Case Reports
- 3-M syndrome – a primordial short stature disorder with novel CUL7 mutation in two Indian patients
- The coincidence of two rare diseases with opposite metabolic phenotype: a child with congenital hyperinsulinism and Bloom syndrome
- Growth hormone deficiency in a child with benign hereditary chorea caused by a de novo mutation of the TITF1/NKX2-1 gene
- Identification of a novel mutation in the PHKA2 gene in a child with liver cirrhosis
Artikel in diesem Heft
- Frontmatter
- Review Article
- Congenital hyperinsulinism: recent updates on molecular mechanisms, diagnosis and management
- Original Articles
- Weight changes of children in 1 year during COVID-19 pandemic
- Three novel mutations of the BCKDHA, BCKDHB and DBT genes in Chinese children with maple syrup urine disease
- Rates of adrenal insufficiency using a monoclonal vs. polyclonal cortisol assay
- Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis
- Identification of three novel pathogenic mutations in cystathionine beta-synthase gene of Pakistani intellectually disabled patients
- The prevalence of incidental finding of gynecomastia on thoracic computed tomography in the pediatric age group
- The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou
- Investigation of androgen receptor gene CAG repeat length polymorphism in pubertal gynecomastia
- A single-centre study of genetic mutations, audiology, echocardiogram and pulmonary function in Saudi children with osteogenesis imperfecta
- A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts
- Clinical, pathological and molecular spectrum of patients with glycogen storage diseases in Pakistan
- Allelic dropout in PAH affecting the results of genetic diagnosis in phenylketonuria
- Short Communication
- Role of the SARS-CoV-2 virus in the appearance of new onset type 1 diabetes mellitus in children in Gran Canaria, Spain
- Case Reports
- 3-M syndrome – a primordial short stature disorder with novel CUL7 mutation in two Indian patients
- The coincidence of two rare diseases with opposite metabolic phenotype: a child with congenital hyperinsulinism and Bloom syndrome
- Growth hormone deficiency in a child with benign hereditary chorea caused by a de novo mutation of the TITF1/NKX2-1 gene
- Identification of a novel mutation in the PHKA2 gene in a child with liver cirrhosis
