Hyperinsulinemic hypoglycemia and thrombocytopenia in a neonate: Treatment and review of literature

Transient hyperinsulinism and thrombocytopenia can occur in neonates following exposure to perinatal stress and birth asphyxia. However, little is known about whether there is a direct association between neonatal hyperinsulinism and thrombocytopenia. We report a case of transient hyperinsulinism and thrombocytopenia, both of which improved after administration of diazoxide in a full-term neonate born by emergency cesarean section and required resuscitation. The newborn had severe hypoglycemia at 8 h of life and continued to have episodes of hypoglycemia while on a continuous glucose infusion rate. The glucagon stimulation test was positive confirming hyperinsulinism and the patient was started on diazoxide. Concomitantly, the neonate also had severe thrombocytopenia and required four platelet transfusions in the first 8 days. Within 24 h after starting diazoxide, both blood glucose and platelet counts improved. We speculate a possible association of hyperinsulinism with thrombocytopenia.

VIVO Weill Cornell Medical College