Page 201 - Abstract Book KONIKA 18

Endocrinology

P-ENDO-049
Management of Persistent Hyperinsulinemia Hypoglycemia of Infancy
Adkhiatul Muslihatin, Muhammad Faizi, Nur Rochmah,
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Hyperinsulinemia hypoglycemia (HH) is a rare case and can cause neurological and
developmental sequelae. Management of HH still remains a challenge due to limitation of diagnostic and
therapeutic modalities. Objective To report the case of PHHI, focusing on the diagnosis and treatment.
Case A 9-day-old boy, 3800 gr, referred with chief complain seizure. Blood glucose level was 32 mg/dL
and the patient had seizure, jittery, lethargy, cyanosis, and feeding problems. The condition was improved
when dextrose bolus administered. The laboratory examination also revealed hyperinsulinemia and
hypoketonemia. There was no structural impairment of brain parenchyma, infarction, mass, and hemorrhagic
from head ultrasonography. The glucose infusion rate (GIR) needed to be increased to 20 mg/kgBW/minute.
Nifedipin orally and octreotide syringe pump was administered. Octreotide syringe pump was replaced with
subcutaneous injection and GIR was decreased gradually based on response. At 32 day of hospitalization,
nd
the patient had stable condition with no hypoglycemia and seizure event and was planned to be discharged.
The patient had been off treatment without any period of hypoglycemia at 11 months of age. Unfortunately, in
the current condition patients with developmental and neurological sequelae. Conclusion Infants with PHHI
are at a high risk of severe neurological damage due to severe hypoglycemia. Our patient has developmental
and neurological sequelae even though had been off treatment.
Keywords: persistent hyperinsulinemia hypoglycemia of infancy; hyperinsulinemia hypoglycemia;
infancy

P-ENDO-050
Sars Cov-2 Infection in Children with Obesity, Type 2 Diabetes Mellitus,
and Metabolic Syndrome: A Case Report

Bina Akura, Martinus M. Leman, Samuel Harmin
Pediatric Endocrinologist, Fatmawati Hospital, Pediatrician, Harapan Bunda Hospital, Jakarta Timur, Indonesia
Abstract
Background Pandemic of SARS-COV2 in Indonesia has immediate implications for therapy of common
metabolic disorders especially type 2 diabetes mellitus. Individuals with obesity and type 2 diabetes is
emerging important comorbidity for disease severity in the context of SARS-COV2. Most of adolescents
who had contracted with COVID-19 would only have minor symptoms. In this case, the boy had moderate
symptoms probably due to his obesity and diabetic comorbidity. Objective To demonstrate and discuss
management of SARS-COV2 infection in type 2 diabetes mellitus in children Case 14-year-old, weight 100
kg, height 170 cm, referred to private hospital with the chief complaint fever, cough and rhinorhea since one
day before admission. Patient also had complaint of headache and no dyspneu. From examination patient
was obese with BMI 34.6 (>P97 CDC BMI chart). Patient had PCR SARS-COV2 test and thoracic CT
SCAN. The result of PCR SARS-COV2 was positive, thoracic CT-SCAN showed ground glass opacity and
hyperglycemia with Hba1c was 11 % and hypercholesterolemia, hypertriglyceridemia. During the treatment
patient had shortness of breath and prolongation of d dimer result. Patient was treated with zinc, vitamin C,
vitamin D, favipiravir, enoxaparine, antibiotic. Patient was also treated with insulin, metformin and dietary
management. After 14 days of treatment, patient showed improvement with recovery in d dimer result and
thoracic CT SCAN showed recovery, even the PCR test still positive. After 21 days of treatment, patient
had negative PCR result.
Keywords: SARS-COV2; obesity; type 2 diabetes mellitus; metabolic syndrome

KONIKA XVIII Abstract Book 153