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Hyperinsulinism and overgrowth without obesity
S Srinivasan1, M J Waters, J E Rowland
1Sydney Children's Hospital, Sydney, Australia.
Archives of Disease in Childhood
|March 26, 2003
Summary
A child
Area of Science:
- Pediatric endocrinology
- Growth disorders
- Metabolic diseases
Background:
- Postnatal overgrowth and hyperinsulinaemia can present in children.
- Elevated insulin-like growth factor 1 (IGF-1) is often associated with growth abnormalities.
- Pituitary abnormalities and growth hormone excess are common causes of overgrowth.
Observation:
- A 5-year-old girl exhibited postnatal overgrowth (height velocity >97th centile) and hyperinsulinaemia.
- She had increased insulin-like growth factor 1 for age, with no evidence of growth hormone excess or pituitary issues.
- Over two years, she developed acanthosis nigricans and diabetes mellitus.
Findings:
- The patient's overgrowth may stem from hyperinsulinism.
- Her serum contains an unidentified factor stimulating lymphocyte precursor proliferation, potentially causing overgrowth.
- This unidentified factor is neither insulin nor IGF-1.
Implications:
- This case highlights a potential novel mechanism for childhood overgrowth.
- The findings suggest a possible link between lymphocyte proliferation and metabolic/growth disturbances.
- Further research is needed to identify the serum factor and its role in acanthosis nigricans and diabetes mellitus.
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