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dc.rights.licensehttp://creativecommons.org/licenses/by-nc-sa/3.0/ve/
dc.contributor.authorFernández, Maricelia
dc.contributor.authorRojas, Gerardo
dc.contributor.authorVielma, Marly
dc.contributor.authorBriceño, Yajaira
dc.contributor.authorPaoli, Mariela
dc.date.accessioned2009-09-09T15:02:53Z
dc.date.available2009-09-09T15:02:53Z
dc.date.issued2009-09-09T15:02:53Z
dc.identifier.issn1690-3110es_VE
dc.identifier.urihttp://www.saber.ula.ve/handle/123456789/29360
dc.description.abstractObjetivo: Presentar el caso de una recién nacida (RN) portadora de Hipoglicemia Hiperinsulinémica transitoria, patología de etiología variable, cuya incidencia es de 1/40.000 nacidos vivos. Se hace una revisión de la literatura. Caso Clínico: RN femenina a término, pequeña para la edad gestacional, de 2 días de vida, quien presenta movimientos tónico-clónicos generalizados, succión débil, e hipotonía, refractarios a tratamiento. Madre no diabética. Al examen físico: Peso: 2.100 gr, talla: 48 cms. Piel con leve tinte ictérico. Hipoactiva, con llanto agudo. Laboratorio: Glicemia central 7 mg/dL y capilar: 13 mg/dL, Insulina 30,8 mU/mL, Cortisol 5,68 µg/dL, Hormona de Crecimiento 25,8 ng/mL. Perfil tiroideo, gasometría y hemograma normal, bilirrubina elevada. Recibe aporte de dextrosa a razón de 8 mg/kg/min más un bolus de dexametasona (0,6 mg/stat). A las 12 horas de su ingreso y luego de iniciar la primera dosis de hidrocortisona (5 mg/kg/día) presentó: Glicemia basal 13 mg/dL, Insulina basal 16,8 mU/mL, Triglicéridos: 160 mg/dL, Colesterol 87 mg/dL, C-HDL 39 mg/dL. Estuvo hospitalizada durante 2 semanas con aporte continuo de dextrosa a razón de 9 mg/kg/min e hidrocortisona; evoluciona satisfactoriamente, con disminución progresiva de la necesidad de aporte de glucosa y de esteroides. Se egresa con glicemia de 50 mg/dL e insulina de 3 µU/mL. Conclusión: La hipoglicemia transitoria es frecuente en los primeros 5-7 días de vida. Se debe pensar en hipoglicemia hiperinsulinémica cuando los niveles de insulina son inapropiadamente elevados en estados de hipoglicemia, los requerimientos de glucosa son mayores de 6-8 mg/kg/min y el amonio está ligeramente elevado. Es prioritario tratar adecuadamente la hipoglicemia para prevenir secuelas neurológicas. Los casos transitorios en su mayoría son de resolución espontánea.es_VE
dc.language.isoeses_VE
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectNeonatoes_VE
dc.subjectHipoglicemia hiperinsulinémicaes_VE
dc.titleHipoglicemia Hiperinsulinémica Neonatal Transitoria: a propósito de un casoes_VE
dc.title.alternativeTransient neonatal hyperinsulinemic hypoglycemiaes_VE
dc.typeinfo:eu-repo/semantics/article
dc.description.abstract1Objective: To report the case of a female newborn with transient hyperinsulinemic hypoglicemia which is a condition with several causes and an incidence of 1 in 40000 born alive babies. A review of the medical literature is done. Clinical Case: A female newborn from a complete pregnancy, with small size for her gestational age, presented at the age of two days with generalized tonic clonic movements, weak sucking and hypotonia that did not respond to medical treatment. Her mother was not diabetic. Physical Exam: Weight 2100 g, Height 48cm. There was a slight jaundiced color in the skin. She was hypoactive with an acute cry. Laboratory: Glycemia: 7 mg/dL. Capillary blood glucose: 13 mg/dL. Serum insulin levels: 30.8 mU/mL, Cortisol: 5.68ug/dL, Human growth Hormone: 25.8 ng/mL. Thyroid function tests, complete blood count and arterial blood gases were normal. Serum bilirrubin high. She received intravenous glucose at a rate of 8 mg/kg/min and Dexamethasone 0.6 mg in I.V. bolus. Twelve hours after her admission with a treatment with hydrocortisone, 5 mg/Kg/day, her blood glucose was 13 mg/dL, her serum insulin 16.8 mU/mL, triglycerides 160 mg/dL, Total cholesterol 87 mg/dL, C-HDL 39 mg/dL. She remained in the hospital for two weeks receiving an intravenous infusion of glucose (9 mg/kg/min) and hydrocortisone. The baby had a satisfactory evolution with a gradual lowering of her glucose needs as well as of glucocorticoids. She was discharged with a blood glucose level of 50 mg/dL and her insulin level was 3 mU/mL. Conclusion: Transient hypoglycemia is a frequent finding in babies at an age of 5-7 days. The diagnosis of hyperinsulinemic hypoglycemia should be thought when insulin levels are inappropriately elevated in states of hypoglycemia, the glucose requirements are higher than 6-8 mg/kg /min and the ammonia is slightly high. To prevent neurologic sequelae, the priority is to treat the hypoglycemia adequately. The majority of the transient cases are of spontaneous resolution.es_VE
dc.description.colacion25-28es_VE
dc.subject.dependenciaSociedad Venezolana de Endocrinología y Metabolismoes_VE
dc.subject.facultadFacultad de Medicinaes_VE
dc.subject.keywordsNeonatees_VE
dc.subject.keywordsHypoglicemiaes_VE
dc.subject.keywordsHyperinsulinemiaes_VE
dc.subject.publicacionelectronicaRevista Venezolana de Endocrinología y Metabolismoes_VE
dc.subject.seccionRevista Venezolana de Endocrinología y Metabolismo: Casos Clínicoses_VE
dc.subject.thematiccategoryMedicina y Saludes_VE
dc.subject.tipoRevistases_VE
dc.type.mediaTextoes_VE


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