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Acute paediatrics
Hyperinsulinism and overgrowth without obesity
  1. S Srinivasan1,
  2. M J Waters2,
  3. J E Rowland2,
  4. R C Baxter3,
  5. C F Verge1
  1. 1Sydney Children’s Hospital, Sydney, Australia
  2. 2Department of Physiology and Pharmacology, University of Queensland, Brisbane, Australia
  3. 3Kolling Institute, Royal North Shore Hospital, Sydney, Australia
  1. Correspondence to:
    Dr C F Verge, Department of Endocrinology, Sydney Children’s Hospital, High Street, Randwick, NSW 2031, Australia;
    vergec{at}sesahs.nsw.gov.au

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

https://doi.org/10.1136/adc.88.4.332

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