Sulfonylurea Poisoning in a Healthy Toddler

Area of Science:

• Pediatric Toxicology
• Endocrinology

Background:

• Sulfonylureas are commonly prescribed oral hypoglycemic agents.
• Accidental ingestion in young children can lead to severe and prolonged hypoglycemia.
• Toddlers and children are particularly vulnerable due to their small body mass and metabolic differences.

Observation:

• A 15-month-old boy accidentally ingested Glipizide.
• The child presented with altered mental status, seizures, and profound hypoglycemia.
• Initial presentation mimicked other pediatric emergencies, highlighting the need for a broad differential diagnosis.

Findings:

• Parenteral dextrose administration was crucial for initial glucose management.
• Octreotide administration effectively inhibited further insulin release, aiding in sustained euglycemia.
• Complete neurological recovery was achieved within 24 hours post-treatment.

Implications:

• Sulfonylurea intoxication must be considered in pediatric patients with unexplained hypoglycemia, especially in households with access to these medications.
• Early recognition and aggressive management are critical for preventing severe neurological sequelae.
• This case underscores the importance of caregiver education regarding safe storage of medications.