Page 193 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-033
Challenges in Therapy of Neonatal Diabetes Mellitus in Restricted Area

Novalina Kaban, Yulisnawati Hasanah, Aditiawati
Department of Child Health, Faculty of Medicine Universitas Sriwijaya/Dr. Mohammad Hoesin General Hospital,
Palembang, South Sumatera, Indonesia
Abstract
Background Neonatal diabetes mellitus (NDM) is a rare metabolic disorder characterized by hyperglycemia
occurring in the first six months of life. It can present as transient NDM caused by overexpression of
chromosome 6q24, which resolves by a few months, or permanent NDM due to mutations in the adenosine
triphosphate-sensitive potassium (KATP) channel (a most common cause of NDM), which continues
throughout life. Objective To report a rare disease with neonatal diabetes mellitus. Case A 3 months old
baby girl was referred with hyperglycemia accompanied by shortness of breath, fever, increased urination,
and growth and development delayed. The patient was born with a low birth weight (2000 grams). There
was no dysmorphic on physical examination. There were hyperglycemia (512 mg/dl), increased of HbA1c
(13%), triglycerides (1000 mg/dl) and low C-peptide level (0.1 ng/dl). The patient was managed as diabetic
ketoacidosis and continued with basal-bolus insulin. We did a sulfonylurea test, but the blood glucose profile
had not been fully controlled. Abdominal ultrasonography showed a smaller pancreas size, and Magnetic
Resonance Imaging Dynamic Contrast revealed pancreas atrophy. Conclusion In this case, the patient
condition leads to permanent NDM caused by pancreas atrophy and need continuous insulin for management.
To determine the prognosis, we have to do a genetic test.

Keywords: neonatal diabetes mellitus; therapy; mutation; insulin; sulfonylurea

P-ENDO-034
A Case of Graves’ Disease in 6-year-old Girl: A Case Report

Ade Ratna Ayu Vitariana, Nur Rochmah, and Muhammad Faizi
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr.Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Graves' disease (GD) is extremely rare in children. Late in recognizing and treatment can
seriously interfere the growth and development. Pediatric patients account for 5% of GD’s total number. The
fatality rate of thyrotoxicosis complication was 10-75%. The symptoms of GD often develop insidiously and
may be interpreted as common complaints of childhood. This become a problem in diagnose of early GD.
We report a case of GD in a 6 years old girl. The diagnostic challenges associated with the early diagnostic
approach. Objective To provide an overview of GD in early childhood Case A 6 years old girl came to
outpatient clinic of Dr. Soetomo Hospital on October 2020. She presented with goiter, exophthalmos,
tachycardia, hyperactivity, difficulty learning at school and moderate malnutrition. She had high thyroid
hormones and Thyrotropin Receptor Antibody (TRAb) levels. The disease had developed since her age 3,5
years. She got Methimazole as a treatment and being observed for her clinical complaints and acceptability
for at least 2 years of treatment. Conclusion There were several improvements of growth and development
patient in this case. She had weight gaining, no complaint of hyperactivities, and improvement of difficulty
learning. It is important to have early diagnose and management therapy of GD.
Keywords: Graves’ disease; thyroid hormone; thyrotropin receptor antibody

KONIKA XVIII Abstract Book 145