Begum-Hasan Jahanara
Department of Pediatrics, Carilion Clinic Children's Hospital, and Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Adv Neonatal Care. 2014 Dec;14(6):392-7. doi: 10.1097/ANC.0000000000000137.
Massive intraventricular hemorrhage associated with hypoglycemia has rarely been reported. We present a late preterm baby girl with severe hypoglycemia after birth. Despite high glucose infusion rates, her glucose levels remained in the 30s to 50s (mg/dL) during the first week of life with a brief period of normoglycemia. On day 2, her computed tomography scan of head showed extensive intraventricular hemorrhage with intraparenchymal extension, which was reported as unexpected for an infant born close to term. She was diagnosed with congenital hyperinsulinemia. Her glucose levels normalized on diazoxide therapy started on day 6. In the absence of any other clear cause, the massive brain hemorrhage was thought to be secondary to prolonged severe hypoglycemia the infant suffered. She remains in global developmental delay at her age at 26 months. This case highlights the importance of early referral of neonatal hypoglycemia for prompt diagnosis and management to avoid the consequences of prolonged low blood glucose.
与低血糖相关的大量脑室内出血鲜有报道。我们报告了一名晚期早产女婴，出生后出现严重低血糖。尽管葡萄糖输注速率很高，但在出生后的第一周内，她的血糖水平仍维持在30至50mg/dL之间，仅有短暂的正常血糖期。在出生第2天，她的头部计算机断层扫描显示广泛的脑室内出血并伴有脑实质内扩展，对于一名近足月出生的婴儿来说，这一情况出乎意料。她被诊断为先天性高胰岛素血症。在第6天开始使用二氮嗪治疗后，她的血糖水平恢复正常。在没有任何其他明确病因的情况下，大量脑出血被认为是婴儿长期严重低血糖的继发后果。在她26个月大时，仍存在全面发育迟缓。该病例强调了早期转诊新生儿低血糖以便及时诊断和管理的重要性，以避免长期低血糖带来的后果。
