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Publication Detail
Severe transient neonatal hyperinsulinism associated with hyperlactataemia in non-asphyxiated infants
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Hussain K, Thornton PS, Otonkoski T, Aynsley-Green A
  • Publication date:
    02/2004
  • Pagination:
    203, 209
  • Journal:
    J PEDIATR ENDOCRINOL METAB
  • Volume:
    17
  • Issue:
    2
  • Keywords:
    A, abnormal, ACIDOSIS, AND, ARTICLE, ASSOCIATION, biochemical, BLOOD, CHILD, child health, CHILDREN, CLINICAL, COMBINATION, COMPLEX, COMPLEXES, DIABETIC, Endocrinology, FEATURES, FOR, GROWTH, GROWTH RETARDATION, HEALTH, hyperinsulinism, Hypoxia, IM, INFANT, INFANTS, INFECTION, INTRAMITOCHONDRIAL, INTRAUTERINE GROWTH, Intrauterine Growth Retardation, IS, JOURNAL, LA, LEVEL, LONDON, MARKER, MEASUREMENT, Mechanism, METABOLISM, METABOLITES, MOTHERS, NEONATAL, NEONATE, neonates, OF, paediatric, PATIENT, PLASMA, RESOLUTION, RETARDATION, secondary, stress, THE, UK
  • Addresses:
    The London Centre for Paediatric Endocrinology and Metabolism, Great Ormond Street Hospital for Children and the Institute of Child Health, University College London, UK. K.Hussain@ich.ucl.ac.uk
  • Notes:
    DA - 20040401 IS - 0334-018X LA - eng PT - Journal Article SB - IM
Abstract
Transient hyperinsulinism (HI) occurs in infants born to diabetic mothers, in infants experiencing perinatal asphyxia and in infants with intrauterine growth retardation. The precise mechanism of transient HI in these different aetiologies is not fully understood. Lactic acidosis is commonly seen in neonates as a secondary phenomenon due to hypoxia, hypovolaemia, anaemia and infection. The combination of transient HI and lactic acidosis is rare. We present the clinical and biochemical features of five infants presenting with transient HI associated with hyperlactataemia in the absence of markers of perinatal stress. This combination lasted for 3-4 weeks with complete resolution except in one patient in whom the hyperinsulinism lasted until 6 months before resolution. The precise mechanism of this association is not clear but may be related either to immaturity of the pyruvate dehydrogenase complex or to the accumulation of abnormal intramitochondrial intermediary metabolites. Infants presenting with HI should have a free flowing blood sample drawn for the measurement of plasma lactate levels
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