Abnormal neurodevelopmental outcomes are common in children with transient congenital hyperinsulinism

Hima Bindu Avatapalle, Indraneel Banerjee, Sajni Shah, Megan Pryce, Jacqueline Nicholson, Lindsey Rigby, Louise Caine, Mohammed Didi, Mars Skae, Sarah Ehtisham, Leena Patel, Raja Padidela, Karen E. Cosgrove, Mark J. Dunne, Peter E. Clayton

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Introduction: Neuroglycopenia is recognized to be associated with abnormal neurodevelopmental outcomes in 26-44% of children with persistent congenital hyperinsulinism (P-CHI). The prevalence of abnormal neurodevelopment in transient CHI (T-CHI) is not known. We have aimed to investigate abnormal neurodevelopment and associated factors in T-CHI and P-CHI. Materials and Methods: A cohort of children with CHI (n = 67, age 2.5-5 years) was assessed at follow-up review and noted to have normal or abnormal (mild or severe) neurodevelopmental outcomes for the domains of speech and language, motor, and vision. Children were classified as P-CHI (n = 33), if they had undergone surgery or remained on medical therapy, or T-CHI (n = 34), if medical treatment for hypoglycemia was stopped. Results: Overall, abnormal neurodevelopment was present in 26 (39%) children with CHI, of whom 18 (69%) were severe. Importantly, the incidence of abnormal neurodevelopment in T-CHI was similar to that in P-CHI (30 vs. 47% respectively, p = 0.16). The prevalence of severe abnormal neurodevelopment in speech, motor, and vision domains was similar in both T-CHI and P-CHI children. For this cohort, we found that the severity of disease [based upon maximal diazoxide dose (odds ratio 95% confidence intervals) 1.3 (1.1; 1.5), p = 0.03], and early presentation of CHI
    Original languageEnglish
    Article numberArticle 60
    JournalFrontiers in Endocrinology
    Volume4
    Issue numberMAY
    DOIs
    Publication statusPublished - 2013

    Keywords

    • Congenital hyperinsulinism
    • Developmental delay
    • Hypoglycemia
    • Neurodevelopment
    • Neurological outcome
    • Seizures
    • Transient congenital hyperinsulinism

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