Abstract Ref Number = APCP1043
RECURRENT HYPOGLYCEMIA IN A NEWBORN A CASE REPORT
Tyas Wuri Handayani,Agustini Utari,Arsita Eka Rini
Department of Pediatric Faculty of Medicine Diponegoro University Dr Kariadi Hospital Semarang Department of Pediatrics, Faculty of Medicine, Diponegoro University Dr Kariadi Hospital, Semarang, Indonesia
Background : Hypoglycemia is the most common biochemical finding in the neonatal period. Transient hypoglycemia usually occurs during first few hours of life because of slow or immature fasting adaptation process and usually resolves with feeding or intravenous dextrose. Prolonged or recurrent low glucose levels may lead to long-term neurodevelopmental sequelae. This is a case report of a newborn with recurrent hypoglycemia.
Case Presentation Summary : A 3-days-old male newborn was referred to Dr. Kariadi Hospital due to recurrent hypoglycemia. Previously patients were treated at another hospital due to asphyxia. He was born spontaneously to a healthy G1P0A0 23-year-old mother at 40 weeks gestation and weighed 2900gr and having history diabetes in the family. The infant had Apgar scores of 3-5-8. From physical examination, there were no remarkable abnormalities. Laboratory investigation revealed recurrent severe hypoglycemia (range blood glucose 17–50 mg/dL), WBC 6.600uL, platelets 5000uL, Quantitative CRP of 0,47mg/L, Sodium 126mmol/L, Chloride 92mmol/L, Blood ketone 0,05mmol/L (<0,5mmol/L), Insulin 3,5µIU/mL(3,2 - 28,5µIU/mL), Cortisol 12,64µg/dL (4,3-22,4µg/dL). At the time of treatment, the child was given infusion D15% 12cc/hour with GIR 10mg/kg/min and 12x15ml diet peroral. During the initial treatment, this newborn were never reaches normal blood sugar level, however on the 7th day of treatment he started improvement after increasing the breastmilk intake.
Learning Points/Discussion : Hypoglycemia needs supervision although it occurs transiently. Regular monitoring of GDS during treatment, manage the nutrition regulation by GIR calculation and enteral nutrition are required.
Keywords: Hypoglycemia Recurrent Newborn