Am J Perinatol 2001; 18(4): 175-178
DOI: 10.1055/s-2001-15504
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Transient Hyperinsulinism in an Asphyxiated Newborn Infant with Hypoglycemia

William Clark, Donough O'Donovan
  • Department of Pediatrics, Baylor College of Medicine, Houston, Texas
Further Information

Publication History

Publication Date:
31 December 2001 (online)

ABSTRACT

We describe a case of transient hyperinsulinism in an asphyxiated newborn infant with hypoglycemia. Although hypoglycemia in birth asphyxiated infants is generally attributed to depletion of glycogen stores, we observed severe hyperinsulinism associated with the hypoglycemia. The hypoglycemia was refractory to high glucose delivery rates (25 mg/kg/min), but responded to a combination of octreotide and diazoxide. At 3 weeks of age, the medications were discontinued and infant was normoglycemic on glucose infusion rates of 5-8 mg/kg/min. Subsequent insulin studies were within normal limits. Transient hyperinsulinism should be considered in asphyxiated infants with protracted hypoglycemia and medications designed to suppress insulin secretion may be useful in refractory cases.

REFERENCES

  • 1 Cornblath M, Ichord R. Hypoglycemia in the neonate.  Semin Perinatol . 2000;  24 136-149
  • 2 Lteif A N, Schwenk W F. Hypoglycemia in infants and children.  Endocrinol Metab Clin North Am . 1999;  28 619-646
  • 3 Lagercrantz H, Bistoletti P. Catecholamine release in the newborn infant at birth.  Pediatr Res . 1977;  11 889-893
  • 4 Johnston D I, Bloom S R. Plasma glucagon levels in the term human infant and effect of hypoxia.  Arch Dis Child . 1973;  48 451-454
  • 5 Schultz K, Soltesz G. Transient hyperinsulinism in asphyxiated newborn infants.  Acta Paediatr Hung . 1991;  31 47-52
  • 6 Collins J E, Leonard J V. Hyperinsulinism in asphyxiated and small-for-dates infants with hypoglycaemia.  Lancet . 1984;  2 311-313
  • 7 Bhowmick S K, Lewandowski C. Prolonged hyperinsulinism and hypoglycemia in an asphyxiated, small for gestation infant: case management and literature review.  Clin Pediatr (Phila) . 1989;  28 575-578
  • 8 Stanley C A. Hyperinsulinism in infants and children.  Pediatr Clin North Am . 1997;  44 363-374
  • 9 de Leeuw R, de Vries J I. Hypoglycemia in small-for-dates newborn infants.  Pediatrics . 1976;  58 18-22
  • 10 DeBaun M R, King A A, White N. Hypoglycemia in Beckwith-Wiedemann syndrome.  Semin Perinatol . 2000;  24 164-171
  • 11 Rahier J, Guiot Y, Sempoux C. Persistent hyperinsulinaemic hypoglycaemia of infancy: a heterogeneous syndrome unrelated to nesidioblastosis.  Arch Dis Child Fetal Neonatal Ed . 2000;  82 F108-F112
  • 12 Glaser B, Thornton P, Otonkoski T, Junien C. Genetics of neonatal hyperinsulinism.  Arch Dis Child Fetal Neonatal Ed . 2000;  82 F79-F86
  • 13 Pildes R, Cornblath M, Warren I. A prospective controlled study of neonatal hypoglycemia.  Pediatrics . 1974;  54 5-14
  • 14 Fluge G. Neurological findings at follow-up in neonatal hypoglycaemia.  Acta Paediatr Scand . 1975;  64 629-634
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