Persistent hypoglycemia in congenital syphilis: hyperinsulinemic hypoglycemia with a focal pancreatic lesion
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Mehmet Akyar
,
İpek Guney Varal
,
Gaffari Tunç
,
Ayşe Ören
,
Yasemin Denkboy Öngen
and
Eren Çağan
Abstract
Objectives
Congenital syphilis can cause severe morbidities such as hydrops fetalis, preterm birth, low birth weight, hepatosplenomegaly, pneumonia, hypoglycemia, etc., and mortality. Despite hypoglycemia being reported in congenital syphilis and hyperinsulinism, only one case was described. In this article, we aimed to present a newborn with congenital syphilis born to a syphilitic mother who was diagnosed with persistent hyperinsulinemic hypoglycemia with a focal lesion during follow-up.
Case presentation
A female patient was born with a weight of 2,450 g in the 32+3rd week of pregnancy from a 30-year-old syphilitic mother who had pleural effusion and ascites, cholestasis, thrombocytopenia, and anemia at birth. Hypoglycemia was detected on the 10th day of the patient’s follow-up (47 mg/dL). The patient was unresponsive to diazoxide, and octreotide, nifedipine, and glucagon treatments were started gradually. No variants were detected in the HH gene panel, but a focal pancreatic head lesion was detected in the pancreatic head in fluorine-18 L-3,4 dihydroxyphenylalanine positron emission tomography-computed tomography. Focal lesionectomy was recommended for the patient.
Conclusions
In this article, we present a neonate with severe early congenital syphilis and focal pancreatic lesions with persistent hyperinsulinemic hypoglycemia unresponsive to diazoxide. Although hypoglycemia can be seen in congenital syphilis and has been reported before, hypoglycemia associated with hyperinsulinism is very rare; only a few patients have been presented, and a focal pancreatic lesion has not been previously reported. The pathology is unknown, but pancreatitis may cause this entity.
Acknowledgments
We are grateful to the patient and her family, as reported in this article, for their genuine support.
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Research ethics: Not applicable.
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Informed consent: The consent form was filled out by the parent.
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Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
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Use of Large Language Models, AI and Machine Learning Tools: Not applicable.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
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Articles in the same Issue
- Frontmatter
- Review
- Osteogenesis imperfecta: shifting paradigms in pathophysiology and care in children
- Opinion Paper
- CRH receptor antagonist crinecerfont – a promising new treatment option for patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency
- Original Articles
- Age and sex mark clinical differences in the presentation of pediatric type 1 diabetes mellitus
- Geographic information system mapping and predictors of glycemic control in children and youth with type 1 diabetes: a study from Western India
- Body composition assessment measured via bioelectrical impedance analysis in euthyroid children with newly diagnosed Hashimoto’s thyroiditis
- Outcomes of newborns screened for congenital hypothyroidism in Turkey – a single center experience
- High yield of congenital hypothyroidism among infants attending Children Hospital, Nairobi, Kenya. Facility based study in the absence of newborn screening
- Immune checkpoint inhibitors and endocrinopathies in pediatric brain tumor patients
- Assessment of quality of life in families affected by maple syrup urine disease: a cross sectional study
- Case Reports
- Reninoma: an unusual cause of growth failure
- Persistent hypoglycemia in congenital syphilis: hyperinsulinemic hypoglycemia with a focal pancreatic lesion
- Diagnostic challenges in pediatric Cushing’s disease associated with chronic renal failure: a report of three patients
- A novel de novo missense OTC mutation in an Iranian girl: a case report
