Saud Al-Shanafey1, Hussain Alkhudhur. 1. King Faisal Specialist Hospital and Research Center, PO Box 3354, MBC 40, Riyadh 11211, Saudi Arabia. saud132@hotmail.com
Abstract
INTRODUCTION: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of neonatal hypoglycemia. Feeding plays a major role in its management. We evaluated the magnitude of food aversion among our patients with PHHI. METHODS: A retrospective medical record review was conducted for patients with PHHI managed during the last 15 years. Demographic and clinical data were retrieved, and descriptive data were generated. RESULTS: Forty-two patients (18 were male and 24 were female) were managed for PHHI over the study period. Thirty-three patients had subtotal pancreatectomy, and 9 were managed medically, with a mean follow-up of 5 years. Nineteen patients (45%) had aversion to food, and 9 of them were developmentally delayed. Of 14 patients assessed by a speech pathologist, 5 had aversive sensory behavior, 4 had dysfunctional pharyngeal swallowing, and 5 had a normal assessment. Ten were managed with oral feeding, 4 had gastrostomy feedings, and 5 were managed with oral and nasogastric tube feeds for various periods. CONCLUSIONS: Food aversion is significantly prevalent among patients with PHHI. The presence of food aversion appears to be independent of developmental delay. Aggressive measures to manage food aversion could help in the management of patients with PHHI.
INTRODUCTION: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of neonatal hypoglycemia. Feeding plays a major role in its management. We evaluated the magnitude of food aversion among our patients with PHHI. METHODS: A retrospective medical record review was conducted for patients with PHHI managed during the last 15 years. Demographic and clinical data were retrieved, and descriptive data were generated. RESULTS: Forty-two patients (18 were male and 24 were female) were managed for PHHI over the study period. Thirty-three patients had subtotal pancreatectomy, and 9 were managed medically, with a mean follow-up of 5 years. Nineteen patients (45%) had aversion to food, and 9 of them were developmentally delayed. Of 14 patients assessed by a speech pathologist, 5 had aversive sensory behavior, 4 had dysfunctional pharyngeal swallowing, and 5 had a normal assessment. Ten were managed with oral feeding, 4 had gastrostomy feedings, and 5 were managed with oral and nasogastric tube feeds for various periods. CONCLUSIONS: Food aversion is significantly prevalent among patients with PHHI. The presence of food aversion appears to be independent of developmental delay. Aggressive measures to manage food aversion could help in the management of patients with PHHI.
Authors: Indraneel Banerjee; Lynette Forsythe; Mars Skae; Hima Bindu Avatapalle; Lindsey Rigby; Louise E Bowden; Ross Craigie; Raja Padidela; Sarah Ehtisham; Leena Patel; Karen E Cosgrove; Mark J Dunne; Peter E Clayton Journal: Front Endocrinol (Lausanne) Date: 2016-02-09 Impact factor: 5.555