Costello syndrome and hyperinsulinemic hypoglycemia.
Costello syndrome is characterized by mental retardation, loose skin, coarse facies, skeletal abnormalities, cardiovascular abnormalities (congenital heart defects, cardiomyopathy, rhythm disturbances), and predisposition to neoplasia. Endocrine abnormalities including growth hormone deficiency, adrenal insufficiency, glucose intolerance, parathyroid adenoma with hyperprolactinemia and hypoglycemia have been described. Hypoglycemia has been documented due to growth hormone and cortisol deficiency. We report on two patients with Costello syndrome and persistent hyperinsulinemic hypoglycemia and review the endocrine manifestations of Costello syndrome. Both patients required diazoxide therapy to stop the unregulated insulin secretion and maintain normoglycemia. The mechanism of persistent hyperinsulinism in patients with Costello syndrome is unclear.
Alexander
Saji
S
London Centre for Pediatric Endocrinology and Metabolism, Great Ormond Street, Hospital for Children NHS Trust, London, United kingdom.
Ramadan
Dina
D
Alkhayyat
Haya
H
Al-Sharkawi
Ibrahim
I
Backer
K C Aboo
KC
El-Sabban
Fatma
F
Hussain
Khalid
K
D000015:Abnormalities, Multiple / Q000473:pathology*; D003981:Diazoxide / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy / Q000473:pathology*; D007003:Hypoglycemia / Q000188:drug therapy / Q000473:pathology*; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000473:pathology*; D013577:Syndrome
D003981:Diazoxide