Transient Neonatal Hypocortisolism in Neonates with Hypoglycemia – Coexistence or Cause? Article Swipe
Sunetra Mondal
,
Lakshmi Nagendra
,
Amarta Shankar Chowdhury
,
Rajan Palui
,
Soumyadeep Biswas
,
Devdeep Mukherjee
,
Krishnendu Khan
,
Aritra Sengupta
,
Anupama Pandey
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.4103/ijem.ijem_158_23
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.4103/ijem.ijem_158_23
Introduction: Infants born preterm, with low birth weight (LBW), or with perinatal stress are at high risk for neonatal hypoglycemia. Low cortisol levels have also been demonstrated in this group of neonates, which is often transient. We report a series of neonates with transient hypocortisolism who had neonatal hypoglycemia. Methods: A descriptive study on clinic-biochemical parameters of a group of five neonates who had persistent neonatal hypoglycemia and had demonstrated low cortisol on critical sample testing. Results: All five neonates had birth weights below normal and four were born preterm. A history of perinatal asphyxia was seen in four cases and neonatal sepsis in two. During critical sample testing (when blood glucose [BG] was 2 mIU/ml) was seen in three infants whereas insulin was undetectable in two. The median cortisol during critical sample testing was 1.9 mcg/dl (0.88 – 3.7). Critical GH was normal in all, and ACTH ranged from 7.2 pg/ml to 41.3 pg/ml. None of the infants had overt clinical features of panhypopituitarism or primary adrenal insufficiency. USG brain revealed germinal matrix hemorrhage in two infants, which resolved on follow-up. USG adrenals and electrolytes were normal in all. Four of the five babies were started on oral hydrocortisone, to which they responded well with the resolution of hypoglycemia. No adverse events were noted. On follow-up, the median time to recover of serum cortisol to normal was 4 months. Conclusion: The contribution of transient hypocortisolism to hypoglycemia in infants at risk, including preterm, LBW, or those with perinatal stress, in the presence or absence of hyperinsulinism, is not well known. While the non-specific use of glucocorticoids is not advocated, the role of therapeutic glucocorticoids among at-risk neonates with documented hypocortisolism during hypoglycemia should be an area for research. Close follow-up of these neonates for spontaneous recovery of cortisol levels is warranted.
Related Topics
Concepts
Medicine
Hypoglycemia
Neonatal hypoglycemia
Pediatrics
Hyperinsulinism
Adrenal insufficiency
Hydrocortisone
Primary Adrenal Insufficiency
Perinatal asphyxia
Sepsis
Asphyxia
Internal medicine
Insulin
Pregnancy
Gestation
Insulin resistance
Biology
Genetics
Gestational diabetes
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.4103/ijem.ijem_158_23
- OA Status
- diamond
- References
- 24
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4396522128
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4396522128Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.4103/ijem.ijem_158_23Digital Object Identifier
- Title
-
Transient Neonatal Hypocortisolism in Neonates with Hypoglycemia – Coexistence or Cause?Work title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-03-01Full publication date if available
- Authors
-
Sunetra Mondal, Lakshmi Nagendra, Amarta Shankar Chowdhury, Rajan Palui, Soumyadeep Biswas, Devdeep Mukherjee, Krishnendu Khan, Aritra Sengupta, Anupama PandeyList of authors in order
- Landing page
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https://doi.org/10.4103/ijem.ijem_158_23Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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diamondOpen access status per OpenAlex
- OA URL
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https://doi.org/10.4103/ijem.ijem_158_23Direct OA link when available
- Concepts
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Medicine, Hypoglycemia, Neonatal hypoglycemia, Pediatrics, Hyperinsulinism, Adrenal insufficiency, Hydrocortisone, Primary Adrenal Insufficiency, Perinatal asphyxia, Sepsis, Asphyxia, Internal medicine, Insulin, Pregnancy, Gestation, Insulin resistance, Biology, Genetics, Gestational diabetesTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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24Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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