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Clinical Pediatrics
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Prolonged Hyperinsulinism and Hypoglycemia

In an Asphyxiated, Small for Gestation Infant Case Management and Literature Review

Samar K. Bhowmick, MD

Pediatric Endocrinology and Metabolism Unit, Pediatric Department, USAF Medical Center, Keesler Air Force Base, Mississippi

Christopher Lewandowski, MD

Pediatric Endocrinology and Metabolism Unit, Pediatric Department, USAF Medical Center, Keesler Air Force Base, Mississippi

The authors describe a term female, asphyxiated, small for gestational age (SGA) infant with documented hyperinsulinism and hypoglycemia occurring at approximately 45 hours of age. The hypoglycemia was refractory to a high rate glucose infusion and steroid administration but responded to diazoxide. The subsequent hospital course was complicated by right-sided heart failure and sepsis. With the onset of sepsis, a transient hyperglycemia was noted that required intermittent insulin therapy for 10 days. Hypoglycemia and hyperinsulinism reemerged and responded to diazoxide therapy. An attempt to discontinue diazoxide at age 6 months was aborted at 2 weeks when hyperinsulinism and hypoglycemia recurred. The infant required diazoxide for 7 more months, then she recovered without having any sequalae. The review of this uncommon hypoglycemia etiology in an SGA and asphyxiated infant and the merits of long-term diazoxide treatment are discussed.

Clinical Pediatrics, Vol. 28, No. 12, 575-578 (1989)
DOI: 10.1177/000992288902801205
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