The Investigation of Hypoglycaemia during Childhood

Bonham, James R.

doi:10.1177/000456329303000302

Cited by 13 publications

(23 citation statements)

References 40 publications

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“…31 Mitochondrial respiratory chain disorders, as stated in the previous review, may affect fat oxidation and therefore cause hypoglycaemia indirectly. 1 Isolated hypoglycaemic episodes have been described in patients with complex III and IV deficiency. Mochel et al 49 hypothesized that reduced ATP production inhibits the ATP-dependent enzymes of gluconeogenesis.…”

Section: Lang Investigating Hypoglycaemia In Childhoodmentioning

confidence: 99%

“…1 Gastroenteritis was the commonest cause of hypoglycaemia in infancy in an audit performed on hypopacks collected. 58 It would be expected that in any condition where there was a reduction in nutritional supply due to malabsorption or malnutrition that hypoglycaemia may occur.…”

Section: Group Vi: Other Causes and Associationsmentioning

confidence: 99%

“…Advances in molecular science and diagnostic techniques have assisted in understanding the mechanisms involved in the homeostasis of glucose metabolism at rest and when stressed. The purpose of this review is to update the reader on the advances made in the area since the review by Bonham in 1993. 1 Identification and molecular characterization of disease states also allow more appropriate management to be initiated and prevent unwanted side-effects.…”

Section: Introductionmentioning

confidence: 99%

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Update on investigating hypoglycaemia in childhood

Lang

2011

Ann Clin Biochem

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Identification and investigation of hypoglycaemia in childhood remains an important clinical emergency. Rapid recognition and appropriate management of this clinical state continues to be important in order to prevent neurological damage or even death. The purpose of this review is to provide an update on the advances made in this area since the review by Bonham in this journal in 1993. Advances in molecular science and diagnostic techniques have assisted in understanding the mechanisms involved in the homeostasis of glucose metabolism at rest and when stressed. New disorders causing hypoglycaemia are described using the classification based upon aetiologies, which was used in Bonham's original paper. The development and use of guidelines and pre-assembled packs for investigating hypoglycaemia is also discussed.

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Section: Lang Investigating Hypoglycaemia In Childhoodmentioning

confidence: 99%

Section: Group Vi: Other Causes and Associationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Update on investigating hypoglycaemia in childhood

Lang

2011

Ann Clin Biochem

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“…If the clinical picture, glucose, ammonia and pH have not provided any clues or if there is evidence of raised intracranial pressure or an intracranial abscess is suspected, it is advised that the patient is treated for infection and further tests are requested, including imaging studies of the head. An important cause of coma is drug ingestion, 1,9 be that accidental in the toddler age group or deliberate in the older child. The further laboratory tests to request at this stage include urinary organic and amino acids and blood acylcarnitine pro¢le to exclude an occult metabolic cause.…”

Section: Cause Unknownmentioning

confidence: 99%

Guidelines for the investigation and management of a reduced level of consciousness in children: implications for clinical biochemistry laboratories

2007

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Whenever a child presents to hospital with a reduced level of consciousness, admitting clinicians have to decide the underlying cause rapidly so that the correct emergency treatment can be initiated. Unfortunately, the clinical presentations of many of the possible diagnoses are very similar. The diagnosis often results from investigations within the clinical biochemistry laboratory. In the past, clinicians have had limited guidance on which tests to request when presented with a child with a reduced level of consciousness. Guidelines have recently been developed relating to all aspects of management of the child in a coma. Due to a lack of evidence in the literature regarding the most appropriate first line tests for children with a reduced level of consciousness, a formal consensus process ('Delphi consensus') was performed using a large multidisciplinary panel of experts. The recommendations reached by this process include the list of initial ('core') tests to request for all children with a reduced level of consciousness (excluding those immediately after suffering a convulsion and those involved in obvious trauma). Depending upon the results of these 'core' tests and the clinical condition of the child, further tests may be requested later. The key point is that all the samples have been taken at the time of presentation to provide the best chance of reaching a diagnosis and correctly treating the child. The article reviews the recommended core investigations and further tests and discusses how individual laboratories can help to implement the guidelines jointly with their Emergency and Paediatric Departments.

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“…1 In the neonate, plasma NEFA levels are an important diagnostic aid in patients presenting with metabolic acidosis and/or severe/persistent hypoglycaemia.…”

Section: Introductionmentioning

confidence: 99%

Plasma free fatty acid reference interval in South African neonates in the first week of life

et al. 2010

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Background: Non-esterified fatty acid (NEFA) levels are an important diagnostic tool in the investigation of neonatal hypoglycaemia. NEFA reference intervals have not been reported for neonates previously. Methods: The objective of this study was to determine an NEFA reference interval for neonates. Results: Heparinized plasma obtained from 106 healthy neonates in the first week of life was analysed using the Roche "Free fatty acid, Half-micro test" kit. Results were then analysed statistically for normality (Shapiro-Wilk test) and reference interval determined non-parametrically (bootstrap method). Conclusions: NEFA levels displayed a non-Gaussian distribution and the reference interval (2.5th and 97.5th percentiles) was 0.2-1.5 mmol/L (90% confidence intervals 0.1 -0.3 and 1.4-2.0 mmol/L, respectively). The NEFA reference interval in South African neonates less than a week old is similar to that described in infants (1-12 months), indicating that this reference range can be used over the entire neonatal period.

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The Investigation of Hypoglycaemia during Childhood

Cited by 13 publications

References 40 publications

Update on investigating hypoglycaemia in childhood

Update on investigating hypoglycaemia in childhood

Guidelines for the investigation and management of a reduced level of consciousness in children: implications for clinical biochemistry laboratories

Plasma free fatty acid reference interval in South African neonates in the first week of life

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