DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173789

Assessment of non-ketotic hypoglycaemia in new born attending in Malda Medical College and Hospital

Indranil Dawn, Sk. Jeauddin, Gauranga Biswas, Jadab Kumar Jana

Abstract


Background: Blood glucose level of <40/dl irrespective of period of gestation is known as hypoglycaemia. Nonketotic hypoglycaemia is associated with disorders of fructose or galactose metabolism, hyperinsulinism, fatty acid oxidation and GH deficiency. Aim of our study to detect the new born having clinical manifestations of hypoglycaemia, measure the capillary blood glucose and urinary ketone bodies in neonates with sign and symptoms of hypoglycaemia and to perform detail work up of neonates having non ketotic hypoglycaemia.

Methods: It is hospital based cross-sectional study carried out for one calendar year extending from 01.01.2015 to 31.12.2015.

Results: Thirty-five patients were identified as hypoglycemic Nine patients were diagnosed with non ketotic hypoglycemia for a prevalence of 8.5/100, 00. Two patients had the low growth hormone (GH) levels (0.4 ng/ml and 0.5 ng/ml). Three patients had increased Asparate Aminotransferase (AST) and Alanine Aminotransferase (ALT) level. Three patients increased urinary acetyl-carnitine level.

Conclusions: Patient suffering from different congenital disorder and an extensive and overzealous workup for endocrinopathy or inborn error of metabolism is necessary.


Keywords


Capillary blood glucose, New born baby, Non-ketotic hypoglycaemia, Urinary ketone-bodies

Full Text:

PDF

References


Mark A. Sperling Nelson Text Book of Pediatrics. 2011;16(1):517-531.

Clarke W, Jones T, Rewers A, Dunger D, Klingensmith GJ. Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes. 2009;10(s12):134-45.

Gruppuso PA, Schwartz R. Hypoglycemia in children. Pediatrics in review. 1989;11(4):117-24.

Burton BK. Inborn error metabolism: the clinical diagnosis in early infancy. Pediatrics 1987;79(3):359-69.

Cornblath M, Ichord R. Hypoglycemia in the neonate. Semin Perinatol. 2000;24(2):136-49.

Lucas A, Morley R. Cole TJ. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. Br Med J 1988;297(6659):1304-8.

Sann L. Neonatal hypoglycemia. Biol Neonate. 1990;58(Supp 1):16-21.

Hawdon JM, Ward Platt MP, Aynsley-Green A. Prevention and management of neonatal hypoglycemia. Arch Dis Child. 1994;70:F60-4.

Levitt-Katz LE, Stanley C. Disorders of glucose and other sugars. In: Spitzer AR, editor. Intensive Care of the Fetus and Neonate. St Louis: Mosby-Yearbook Inc; 1996. pp. 982-90.

Haymond MW. Hypoglycemia in infants and children. Endocrinol Metab Clin North Am. 1989;18:211-52.

Pettenati MJ, Haines JL, Higgins RR, Wappner RS, Palmer CG, Weaver DD. Wiedemann-Beckwith syndrome: presentation of clinical and cytogenetic data on 22 new cases and review of the literature. Hum Genet. 1986;74:143-54.

Land JM. Hypoglycemia in the neonate: how and when is it important?. Dev Neurosci. 1994;16(5-6):307-12.

Saudubray J-M, Charpentier C. Clinical phenotypes: Diagnosis/algorithms. In: Scriver CR, Beaudet AL, Sly WS, Valle D, editors. The Metabolic and Molecular Bases of Inherited Disease. 7th edn. New York: McGraw-Hill Inc; 1995. pp. 327-400.

Edstrom CS. Hereditary fructose intolerance in the vomiting infant. Pediatrics. 1990;85:600-3.

Hale DE, Bennett MJ. Fatty acid oxidation disorders: a new class of metabolic diseases. J Pediatr. 1992;121:1-11.

Touma EH, Charpentier C. Medium chain acyl-CoA dehydrogenase deficiency. Arch Dis Child. 1992;67:142-5.

Catzeflis C, Bachmann C, Hale DE. Early diagnosis and treatment of neonatal medium chain acyl-CoA dehydrogenase deficiency: report of two siblings. Eur J Pediatr. 1990;149:577-81.

Blakemore AIF, Singleton H, Pollitt RJ, et al. Frequency of the G985 MCAD mutation in the general population. Lancet. 1991;337:298-9.

Pollitt RJ. Disorders of mitochondrial long chain fatty acid oxidation. J Inher Metab Dis. 1995;18:473-90.

Stanley CA, Baker L. Hyperinsulinism in infancy: Diagnosis by demonstration of abnormal response to fasting hypoglycemia. Pediatrics. 1976;57:702–11.

Grupposo PA, Schwartz R. Hypoglycemia in children. Pediatr Rev. 1989;11:117-24.

Behrman RE, Kliegman RM, Arvin AM, editors. Nelson Textbook of Pediatrics. 15th edn. Philadelphia: WB Saunders; 1996. p. 2068.