A CASE OF HYPOGLYCEMIA…
Keywords:Hypopituitarism, Hypoglycemia, Children.
Introduction: Hypopituitarism is characterized by failure of the pituitary hormone secretion. Clinical presentation is variable and depends on the etiology, evolution and hormonal deficits.
Case: A 2 year-old male child was brought to the emergency room due to sudden change of consciousness. In the neonatal period, he presented with hypoglycemia, thrombocytopenia, jaundice and sepsis with no identified agent. The child showed regular growth (10-25 percentile), adequate psychomotor development and divergent strabismus. The patient was subfebrile with 10 Glasgow Coma Scale. Severe hypoglycemia (26mg/dL) was observed, and it endocrine and metabolic tests were immediately performed that showed low levels of cortisol, and ACTH, GH and TSH deficits. Replacement therapy with hydrocortisone and levothyroxine was started. Neuroimaging showed structural changes with adenohypophysis hypoplasia.
Conclusion: This rare diagnosis demands high degree of suspicion. The progressive development of hormonal deficits requires regular clinical and laboratory evaluations.
Brook C, Clayton P, Brown R. Brook´s Clinical Pediatric
Endocrinology. Quinta Edição. Oxford. Blackwell Publishing.
Ascoli P, Cavagnini F. Hypopituitarism. Pituitary. 2006;
De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K,
Grossman A, Hershman JM, et al. Hypopituitarism. Endotext
– Publicação Online. South Dartmouth (MA): MDText.com,
Cavarzere P, Biban P, Gaudino R, Perlini S, Sartore L, Chini
L, et al. Diagnostic pitfalls in the assessment of congenital
hypopituitarism. Journal of Endocrinological Investigation.
Toogood A, Stewart P. Hypopituitarism: clinical features,
diagnosis, and management. Endocrinology & Metabolism
Clinics of North America. 2008; 37:235-61.
Esoterix - Endocrinology Expected Values and S.I. Unit
Conversion Tables. Laboratory Corporation of America
Melmed S, Polonsky KS, Larsen PR, Kronenberg HM.
Williams Textbook of Endocrinology. 12ª Ed. Saunders.
Tsai S, Laffan E, Lawrence S. A retrospective review of
pituitary MRI findings in children on growth hormone therapy.
Pediatric Radiology. 2012; 42:799-804.
Larson A, Nokoff NJ, Meeks NJ. Genetic causes of pituitary
hormone deficiencies. Discov Med. 2015; 19:175-83.
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