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Iatrogenic diabetes mellitus during ACTH therapy in an infant with West syndrome

Valeria Calcaterra1, Andrea Bottazzi2, Chrissoula Tzialla3

  • 1Department of Pediatrics, University of Pavia and IRCCS Policlinico San Matteo Foundation, P.le Golgi n.2, 27100, Pavia, Italy. v.calcaterra@smatteo.pv.it.

Acta Diabetologica
|January 22, 2011
PubMed

Insights

Adrenocorticotropic hormone (ACTH) therapy for West syndrome can cause iatrogenic diabetes mellitus. Careful monitoring of blood glucose levels is essential during ACTH treatment for infants with this rare epileptic disorder.

Area of Science:

  • Pediatric Neurology
  • Endocrinology
  • Epileptology

Background:

  • West syndrome is a rare infantile epileptic disorder characterized by spasms, hypsarrhythmia, and psychomotor impairment.
  • Adrenocorticotropic hormone (ACTH) is the standard first-line treatment, despite potential adverse effects.

Observation:

  • A rare case of iatrogenic diabetes mellitus occurred during ACTH therapy in an infant with symptomatic West syndrome.
  • The infant exhibited Cushingoid features, hirsutism, biochemical diabetes, adrenal hyperplasia, weight gain, electrolyte imbalances, and infections.

Findings:

  • Excessive glucocorticoid production secondary to ACTH therapy was identified as the cause of diabetes.
  • The patient showed signs of hypercortisolism without mineralocorticoid excess.

Implications:

  • This case highlights a significant, albeit rare, adverse effect of ACTH therapy in West syndrome.
  • Close monitoring of glycemic levels is crucial throughout ACTH treatment to detect and manage potential diabetes development.

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