J Korean Soc Pediatr Endocrinol.  2004 Dec;9(2):194-198.

Prevalence and Clinical Features of Ketotic Hypoglycemia in Childhood

• Kim JY
• Shin JS
• Kim HS
• Lee SJ

Abstract

PURPOSE
Idiopathic ketotic hypoglycemia (IKH) is an important cause of hypoglycemia in children. The purpose of this study was to determine the prevalence of ketotic hypoglycemia and to describe the clinical manifestation.
METHODS
We conducted a retrospective chart review of children presenting hypoglycemia to the emergency department (ED) of Ewha Womans University Hospital between January 1995 and June 2004. Information recorded for subject included age, gender, weight, time of presentation, presenting symptoms, and laboratory data.
RESULTS
Eighty two children were identified for hypoglycemia during the study period. IKH was the ultimate diagnosis for 66 patients (80.5%). Other diagnoses included hyperinsulinism (2.4%), drug adverse event (1.2%), sepsis (1.2%), and other disorder. The mean age for presentation of IKH was 37.9+/-18.6 months. Thirty eight boys and twenty eight girls were identified. The median time of presentation was 9:48 a.m. Of the 66 subjects, body weight of 46.9% patients was below 25th percentile for age. The average blood glucose was 41.4+/-14.2 mg/dL. Symptoms at presentation included lethargy (24.2%), mental change (16.7%) and vomiting (16.7%). 49 patients (74.2%) were described as having a concomitant illness.
CONCLUSION
IKH was responsible for 80.4% of cases of hypoglycemia in pediatric ED and it had usually concomitant intercurrent illness which resulting in poor oral intake. Awareness of IKH, and its presenting characteristics, will be helpful in the ED when taking care of hypoglycemic children.

Keyword

Ketotic hypoglycemia

MeSH Terms

Blood Glucose
Body Weight
Child
Diagnosis
Emergency Service, Hospital
Female
Humans
Hyperinsulinism
Hypoglycemia*
Lethargy
Prevalence*
Retrospective Studies
Sepsis
Vomiting
Blood Glucose