[Diagnosis of congenital endocrinological disease in newborns with prolonged jaundice and hypoglycaemia].
BACKGROUND
The association of prolonged neonatal jaundice and hypoglycaemia may be secondary to an endocrinological disease. Pituitary insufficiency and primary adrenal insufficiency are the most likely endocrine diseases that need to be ruled out.


METHODS
We retrospectively analysed the clinical and laboratory characteristics of thirteen patients referred to the Hospital de Niños Ricardo Gutiérrez between years 2003 and 2008 due to prolonged neonatal jaundice and hypoglycaemia secondary to pituitary insufficiency in twelve patients, and in one secondary to primary adrenal insufficiency.


RESULTS
All patients had a history of neonatal hypoglycaemia. Ten patients had conjugated hyperbilirubinaemia and six also had elevated transaminases. Combined pituitary hormone deficiency was observed in the twelve hypopituitarism patients. Hormonal replacement normalised liver function and resolved the prolonged jaundice in all the patients. None of them underwent liver biopsy. Hypoglycaemia also remitted after hormonal therapy.


CONCLUSIONS
Prolonged or cholestatic jaundice associated with neonatal hypoglycaemia is highly likely to be due to pituitary hormone deficiency or primary adrenal insufficiency. Early diagnosis and treatment of these children reverts the prolonged jaundice and prevents morbidity and mortality due to recurrent hypoglycaemia and hormone deficiencies.
División de Endocrinología, Centro de Investigaciones Endocrinológicas, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina. dbraslavsky@cedie.org.ar
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Braslavsky
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Keselman
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Chiesa
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Bergadá
D004700:Endocrine System Diseases / Q000150:complications* / Q000151:congenital*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007231:Infant, Newborn; D007565:Jaundice / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors