Congenital hyperinsulinemia with grade 4 intraventricular hemorrhage: a case report with a 2-year follow-up

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Endocrinology

Background:

• Congenital hyperinsulinemia is a rare cause of persistent neonatal hypoglycemia.
• Intraventricular hemorrhage (IVH) is a serious complication in preterm infants, but its association with hypoglycemia is infrequently reported.

Observation:

• A late preterm infant presented with severe hypoglycemia unresponsive to high glucose infusion rates.
• Cranial computed tomography revealed extensive intraventricular hemorrhage with intraparenchymal extension on day 2 of life.
• The infant was diagnosed with congenital hyperinsulinemia and treated with diazoxide, achieving normoglycemia.

Findings:

• The extensive intraventricular hemorrhage was considered secondary to prolonged, severe hypoglycemia.
• The infant developed global developmental delay at 26 months of age.

Implications:

• This case underscores the critical need for early recognition and management of neonatal hypoglycemia.
• Prompt intervention can mitigate the risk of severe neurological sequelae, such as developmental delay, associated with prolonged hypoglycemia.