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Hyperinsulinaemic hypoglycaemia in preterm neonates
1London Centre for Paediatric Endocrinology and Metabolism, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. K.Hussain@ich.ucl.ac.uk
Insights
Severe hyperinsulinism (HI) in premature infants is a serious condition causing recurrent hypoglycemia. This study highlights that HI in preterm infants may present as a more aggressive illness, requiring consideration in differential diagnoses.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Metabolic Disorders
Background:
- Hyperinsulinism in infancy (HI) is a primary cause of severe hypoglycemia in newborns.
- Typically observed in term infants, HI in premature infants is rarely reported.
Purpose of the Study:
- To report on the occurrence and characteristics of severe persistent hyperinsulinism in a cohort of prematurely born infants.
- To assess the clinical presentation and management challenges of HI in preterm neonates.
Main Methods:
- Case series report of seven infants born between 31-36 weeks gestation.
- Clinical data including gestational age, birth weight, and management difficulties were analyzed.
Main Results:
- Seven premature infants (31-36 weeks gestation) presented with severe persistent hyperinsulinism.
- Two infants were large for gestational age; all cases were difficult to manage.
- This suggests a potentially more aggressive form of HI in the context of prematurity.
Conclusions:
- Hyperinsulinism in infancy should be considered in the differential diagnosis of severe hypoglycemia in preterm infants.
- The association of HI with prematurity may indicate a more severe clinical course.
- Early recognition and management are crucial for affected preterm neonates.
Abstract:
Hyperinsulinism in infancy (HI) is an important cause of severe and recurrent hypoglycaemia in newborn infants. It usually appears in infants born at term, and only one case of its occurrence in a prematurely born infant has been reported as an incidental finding. This is a report of seven infants born at 31-36 weeks gestation who experienced severe persistent hyperinsulinism. Two infants were large for dates. All infants were difficult to manage, suggesting that the occurrence of HI with prematurity may be associated with a particularly aggressive illness. HI should be considered in the differential diagnosis of severe hypoglycaemia in preterm infants.
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