Stress hyperglycaemia as a result of a catecholamine producing tumour in an infant.
Hyperglycaemia commonly occurs in children presenting at the emergency department. In the absence of diabetic symptoms, this stress-related hyperglycaemia is considered a benign condition. We present a malignant cause of hyperglycaemia in an 11-month-old girl with concomitant symptoms of a neuroendocrine malignancy. One month earlier, she had undergone an episode of stress-related hyperglycaemia concurrent with fever during an upper respiratory tract infection. Current glucose level was 234 mg/dL (13 mmol/L) and the glycosylated haemoglobin level was 44 mmol/mol (6.2%) without metabolic acidosis. We observed periods of hyperglycaemia, sweating, flushing, hypertension and tachypnoea. Urinalysis showed high amounts of catecholamine intermediates. Abdominal ultrasound revealed a mass originating in the right adrenal gland. Histology confirmed the diagnosis of neuroblastoma. Hyperglycaemia in this patient was the first presenting symptom of a metabolically active neuroblastoma.
Department of Pediatrics, HAGAziekenhuis/Juliana Children's Hospital, The Hague, The Netherlands.
Anne Mariëtte
AM
de Grauw
Diabeter, National Centre for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands.
Dick
D
Mul
Department of Pediatric Oncology/Hematology, Sophia Children's Hospital, Rotterdam, The Netherlands.
Max M
MM
van Noesel
Department of Pediatric Infectious Diseases and Immunology, Sophia Children's Hospital, Rotterdam, The Netherlands.
Emilie P
EP
Buddingh
D002395:Catecholamines / Q000378:metabolism*; D005260:Female; D005334:Fever; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000378:metabolism*; D006973:Hypertension / Q000209:etiology / Q000473:pathology*; D007223:Infant; D009447:Neuroblastoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D002395:Catecholamines