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Piro E, Schierz IAM, Antona V, Pappalardo MP, Giuffrè M, Serra G, Corsello G. Neonatal hyperinsulinemic hypoglycemia: case report of kabuki syndrome due to a novel KMT2D splicing-site mutation. Ital J Pediatr 2020; 46:136. [PMID: 32948218 PMCID: PMC7499940 DOI: 10.1186/s13052-020-00902-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/15/2020] [Indexed: 12/19/2022] Open
Abstract
Background Persistent neonatal hypoglycemia, owing to the possibility of severe neurodevelopmental consequences, is a leading cause of neonatal care admission. Hyperinsulinemic hypoglycemia is often resistant to dextrose infusion and needs rapid diagnosis and treatment. Several congenital conditions, from single gene defects to genetic syndromes should be considered in the diagnostic approach. Kabuki syndrome type 1 (MIM# 147920) and Kabuki syndrome type 2 (MIM# 300867), can be associated with neonatal hyperinsulinemic hypoglycemia. Patient presentation We report a female Italian (Sicilian) child, born preterm at 35 weeks gestation, with persistent hypoglycemia. Peculiar facial dysmorphisms, neonatal hypotonia, and cerebellar vermis hypoplasia raised suspicion of Kabuki syndrome. Hyperinsulinemic hypoglycemia was confirmed with glucagon test and whole-exome sequencing (WES) found a novel heterozygous splicing-site mutation (c.674-1G > A) in KMT2D gene. Hyperinsulinemic hypoglycemia was successfully treated with diazoxide. At 3 months corrected age for prematurity, a mild global neurodevelopmental delay, postnatal weight and occipitofrontal circumference growth failure were reported. Conclusions Kabuki syndrome should be considered when facing neonatal persistent hypoglycemia. Diazoxide may help to improve hyperinsulinemic hypoglycemia. A multidisciplinary and individualized follow-up should be carried out for early diagnosis and treatment of severe pathological associated conditions.
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Affiliation(s)
- Ettore Piro
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy.
| | - Ingrid Anne Mandy Schierz
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy
| | - Vincenzo Antona
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy
| | - Maria Pia Pappalardo
- Pediatric Radiology Unit, A.R.N.A.S. Ospedali Civico Di Cristina Benfratelli, Piazza N. Leotta, 4, 90127, Palermo, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy
| | - Gregorio Serra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy
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de Sousa Veiga A, Nunes Rabelo N, Duarte Batista W, Mayumi Matucuma A, da Silva Brito J, Cintra Husni M. Primary megalocornea: Case report. Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:201-204. [PMID: 32057558 DOI: 10.1016/j.oftal.2019.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/14/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
The neonate has a horizontal diameter of the cornea, usually up to 10mm with growth up to 2mm in the first 2 years of life. We report a case of megalocornea, a rare, recessive, X-linked disorder in a 3-month-old child, seeking to review what the medical literature brings information about the condition, as well as diagnostic and follow-up parameters, of its main differential diagnoses.
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Affiliation(s)
- A de Sousa Veiga
- Centro de Referencia de Glaucoma y Cataratas, Santa Casa de Belo Horizonte, Belo Horizonte, Brasil
| | - N Nunes Rabelo
- Centro de Referencia de Glaucoma y Cataratas, Santa Casa de Belo Horizonte, Belo Horizonte, Brasil
| | - W Duarte Batista
- Centro de Referencia de Glaucoma y Cataratas, Santa Casa de Belo Horizonte, Belo Horizonte, Brasil
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