Page 182 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-011
Growth and Thyroid Function of Pediatric Patients
with Congenital Heart Disease at RSUP Dr. M Djamil Padang

Wenny Rahmalia Rezki, Eka Agustia Rini
Department of Child Health, Faculty of Medicine Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indonesia

Abstract
Background Congenital Heart Diasease is the most common congenital disease in children, of which 49% of
the cases have growth disorders.Thyroid function is among important factors contributed to normal growth
in children. Objective To describe growth profile and thyroid function in pediatric patients with congenital
heart disease. Methods A Cross sectional study was conducted by measuring body height, FT4 and TSH
level in 21 patients of congenital heart disease at pediatric ward of Dr M Djamil Hospital from May until
June 2021. Results Twelve patients (57.1%) had a body height of p ≤ 3 (WHO 2007), of which 41.6%
showing familial short stature and 58.3% pathologic short stature. Out of 21 patients with congenital heart
disease, nine patients had normal level of FT4 (42.8%), ten patients with low level of FT4 (47.6%), and
two patients with elevated level of free T4 (9.5%). Fourteen patients had normal TSH level (66.67%), while
three patients had low level of TSH (14.2%) and two patients with elevated TSH level. Seven patients had
normal level of FT4 and TSH (33.3%), two patients with low level of FT4 and high level of TSH (9.5%).
Conclusions Congenital heart disease children may experience growth disturbance, thyroid dysfunction
Keywords: congenital heart disease; height profile; thyroid function

P-ENDO-012
Approaching Diagnosis and Treatment of Refractory Hypoglycemia in Children
due to Hyperinsulinism in 4-year-old Girl: A Case Report

Yasmin Musfirah, Indra Widjaya Himawan,
Department of Child Health, Faculty of Medicine Universitas Lambung Mangkurat,
Idaman General Hospital, Banjarbaru, South Borneo, Indonesia

Abstract
Background Hypoglycemia is a rare condition in children over 6 months old (0.034%). One of the most
common etiology of refractory hypoglycemia is hyperinsulinism (HI). Mutations in ABCC8 and KCNJ11
gene account for the main genetic cause of HI. Objective To describe approaching diagnosis of etiology of
refractory hypoglycemia in pediatric. Case A 4 years old girl came to hospital due to 2 hours decrease of
consciousness. No history of severe activity, Kussmaul’s breathe pattern, nor history of increase of urination
frequency and volume. GCS was E1V1M1. Vital sign, physical examination and anthropometric status
were normal. Random blood glucose level was 47g/dL and increased to 146g/dL after given D10% (GIR:
4.7) and dexamethasone. Complete blood count and urinalysis within normal limits. Fasting insulin level
and C-peptide increased (35.4 mU/L and 10 ng/mL respectively) while ketone level decreased. Head and
pancreas CT-Scan were normal. Dexamethasone change into hydrocortisone IV after 10 days accompanied
by somatostatin IV. Nifedipine 2.5 mg t.i.d given on 16th day. Somatostatin stopped due to headache. Patient
was discharged with PO hydrocortisone 10 mg bid and Nifedipine was still on same dosage. Random blood
glucose stable with lowest level was above 55 mg/ dL. The patient was planned to perform genetic testing.
Conclusion Hyperinsulinism is a rare case but important cause of hypoglycemia in children. The diagnosis
of hypoglycemia requires a multidisciplinary approach. Genetic testing was required to identify the mutated
gene that cause hypoglycemia hyperinsulinism.
Keywords: pediatric hypoglycemia; hyperinsulinism; hypoglycemia hyperinsulinism

134 KONIKA XVIII Abstract Book