A CASE OF HYPOGLYCEMIA…
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v25.i2.9525Keywords:
Hypopituitarism, Hypoglycemia, Children.Abstract
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.
Downloads
References
Brook C, Clayton P, Brown R. Brook´s Clinical Pediatric
Endocrinology. Quinta Edição. Oxford. Blackwell Publishing.
Ascoli P, Cavagnini F. Hypopituitarism. Pituitary. 2006;
:335-42.
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,
Inc.; 2000-15.
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.
; 37:1201-9.
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
(2011).
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.
Downloads
Published
How to Cite
Issue
Section
License
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.