Article Text
Acute paediatrics
Hyperinsulinism and overgrowth without obesity
Abstract
We report a 5 year old girl with postnatal overgrowth (height velocity >97th centile), hyperinsulinaemia, and increased insulin-like growth factor 1 for age, without evidence of bioactive or immunoreactive growth hormone excess or pituitary abnormality. Although her overgrowth may be a result of hyperinsulinism, her serum contains a factor (neither insulin nor IGF-1) which is able to stimulate the proliferation of lymphocyte precursors, and this could also account for the overgrowth. Over the course of two years observation she has developed acanthosis nigricans and diabetes mellitus.
- diabetes mellitus
- insulin
- growth factor
- overgrowth
- ACTH, adrenocorticotrophic hormone
- ALS, acid labile subunit
- DHEAS, dehydroepiandrosterone sulphate
- FSH, follicle stimulating hormone
- GH, growth hormone
- GHBP, growth hormone binding protein
- IGF, insulin-like growth factor
- IGFBP, IGF binding protein
- LH, luteinising hormone
- NCHS, National Centre for Health Statistics
- OGTT, oral glucose tolerance test
- SDS, standard deviation score
- TSH, thyroid stimulating hormone
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- ACTH, adrenocorticotrophic hormone
- ALS, acid labile subunit
- DHEAS, dehydroepiandrosterone sulphate
- FSH, follicle stimulating hormone
- GH, growth hormone
- GHBP, growth hormone binding protein
- IGF, insulin-like growth factor
- IGFBP, IGF binding protein
- LH, luteinising hormone
- NCHS, National Centre for Health Statistics
- OGTT, oral glucose tolerance test
- SDS, standard deviation score
- TSH, thyroid stimulating hormone