1. Hypoketotic hypofattyacidaemic hypoinsulinaemic hypoglycaemia in a child with hemihypertrophy? A new syndrome.
- Author
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Hussain K, Bodamer OA, Cameron FJ, Camacho-Hubner C, Soos MA, Jones J, Krywawych S, O'Rahilly S, and Aynsley-Green A
- Subjects
- Autoantibodies blood, Blood Glucose metabolism, Child, Preschool, Fasting, Glucagon administration & dosage, Glucose biosynthesis, Humans, Hypertrophy, Hypoglycemia diet therapy, Injections, Intravenous, Insulin Antibodies blood, Insulin-Like Growth Factor II, Liver metabolism, Male, Phosphorylation, Protein Precursors blood, Receptor, IGF Type 1 metabolism, Receptor, Insulin metabolism, Syndrome, Abnormalities, Multiple pathology, Fatty Acids blood, Hypoglycemia blood, Hypoglycemia complications, Insulin blood, Ketone Bodies blood
- Abstract
Background: Recurrent and persistent hypoketotic, hypofattyacidaemic hypoglycaemia in infancy and childhood is most frequently due to hyperinsulinism of infancy. This biochemical profile can also be due to non-islet cell tumour hypoglycaemia or circulating insulin-receptor autoantibodies. Hyperinsulinaemic hypoglycaemia is also seen in children with the Beckwith-Wiedemann syndrome, where it is usually transient., Methods/results: We report a novel case of child with hemihypertrophy and severe persistent hypoketotic, hypofattyacidaemic hypoinsulinaemic hypoglycaemia. No 'big' pro-IGF2 forms or circulating insulin-receptor antibodies were found. Glucose and protein isotope turnover studies showed marked suppression of hepatic glucose production during fasting. There was no evidence for constitutive autophosphorylation of the insulin or IGF-1 receptor, and no evidence for up-regulation of IGF-1 receptor., Conclusion: The precise pathophysiology of this novel case is still unclear., (Copyright 2004 S. Karger AG, Basel)
- Published
- 2004
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