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Case report: Fatal cerebral herniation caused by hypoglycemic due to mistaking glibenclamide in children

Chunlan Song1, Wanyu Jia1, Shengli Shi1

  • 1Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China.

Frontiers in Behavioral Neuroscience
|April 10, 2023
PubMed

Insights

A child in China accidentally ingested glibenclamide, a diabetes medication, leading to fatal hypoglycemia and brain herniation. This case highlights the critical need for awareness of accidental drug ingestion in children.

Area of Science:

  • Pediatrics
  • Toxicology
  • Endocrinology

Background:

  • Glibenclamide is a common hypoglycemic agent used in China.
  • Increased prevalence of diabetes and a significant population of 'left-behind' children in China raise concerns for accidental medication ingestion.
  • Accidental ingestion of medications by children is a serious public health issue.

Observation:

  • A case report details a child who mistakenly ingested glibenclamide.
  • The child developed severe hypoglycemia, leading to cerebral edema and brain herniation.
  • This represents the first reported pediatric fatality from glibenclamide-induced brain herniation in China.

Findings:

  • Accidental glibenclamide ingestion can cause severe hypoglycemia in children.
  • Hypoglycemia can rapidly progress to life-threatening complications like cerebral edema and brain herniation.
  • Delayed recognition and treatment of hypoglycemia increase mortality risk.

Implications:

  • Clinicians must consider accidental glibenclamide ingestion in children presenting with unexplained seizures and coma.
  • Detailed medical history is crucial for diagnosing non-obvious causes of pediatric emergencies.
  • Prompt administration of high-concentration glucose is vital for managing hypoglycemia and preventing severe neurological damage.
  • Pediatricians should maintain a high index of suspicion for accidental medication exposure in children with altered consciousness.

Keywords:
cerebral herniachildrenglibenclamidehypoglycemic comamistake

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