ESPE Abstracts (2016) 86 P-P1-567

Risk Factors and Clinical Features of a Large Cohort of Patients with Transient Hyperinsulinemic Hypoglycaemia

Elif Ozsua, John Reeda, Alsaffar Hussaina, Prashant Patilb, Dinesh Giria, Poonam Dharmaraja, J O Blaira, Urmi Dasa, Senthil Senniappana & Mohommad Didia


aAlder Hey Chidren Hospital, Liverpool, UK; bBharti Vidyapith Medical College and Medical Research Centre, Pune, Maharashtra, India


Background: Transient hyperinsulinemic hypoglycaemia (THH) is associated with risk factors such as prematurity, maternal diabetes mellitus, perinatal hypoxia, small for gestational age (SGA) and syndromes like Beckwith Wiedemann syndrome (BWS).

Objective: To present the features of a large cohort of patients with THH managed at a Quaternary referral centre.

Method: Patients who had neonatal onset HH that resolved before the 2nd birthday were considered to have THH. Retrospective data was collected over a period of 6 years to the identify risk factors, medications used and duration of treatment for THH.

Results: Out of the 85 THH patients (59 males), 27 (31%) were born preterm. 10/27 of the preterm infants (37%) and 15/60 of the term infants (25%) were SGA. Two preterm (7%) and two term (3%) infants had BWS. Three patients (3.5%) with confirmed hyperinsulinism resolved without medical treatment. The table gives risk factors, medications used and duration of treatment.

Conclusion: Prematurity and SGA are the major risk factors for THH. There is no difference in the total duration of treatment between the preterm and term infants. Whilst almost half the preterm infants had three risk factors or more, nearly 30% of term infants had no identifiable risk factor that potentially trigger the unregulated insulin release leading to severe hypoglycaemia.