A case of congenital hyperinsulinism in a child with hypoxic-ischemic CNS damage

This article presents a clinical case of a patient with congenital hyperinsulinism. The girl, born on in a state of moderate severity due to symptoms of respiratory failure, neurological symptoms, on the 1st day of her life was transferred to department of pathology of newborn and premature infants from the maternity hospital of the city clinical hospital. During the observation period, persistent hypoglycemia was noted in the department, which was corrected by intravenous infusion of 10% glucose, when attempting to cancel intravenous drip administration of 10% glucose, episodes of hypoglycemia (up to 1.8mmol/l) resume. Taking into account the increase in blood insulin levels to 67.2 mg/l, the patient was transferred to the Scientific Research Institute of Obstetrics and Pediatrics (NIIAP) for further examination and choice of treatment tactics. During hospitalization at the NIIAP, the diagnosis was established: Congenital hyperinsulinism — against the background of hypoglycemia, 1.2 mmol /l insulin level — 10 µmed /ml. From 01.07.2024, with the consent of the mother, according to vital indications, Diazoxide (Proclicum) therapy at a dose of 20 mg / day (5.0 mg / kg/ day) was started in the department under the control of glycemia, against the background of which there was a tendency to stabilize glycemic indices, fluctuations in the level of glycemia according to the glucose meter from 2.7 mmol / l to 5.0 mmol / l, from 08.07.24 the abolition of infusion therapy of 10% glucose. The therapy is tolerated satisfactorily; no significant side effects were found. However, given the persistent hypoglycemia of 2.7 mmol / l against the background of the fasting interval, the dose of Diazoxide was increased to 25 mg / day (5.5 mg / kg / day). The child continues to be in the hospital.