[Long-term follow-up of permanent neonatal diabetes in Tunisian infant]. / Evolution à long terme d'un diabète néonatal permanent chez un enfant tunisien.
Ann Endocrinol (Paris)
; 71(4): 314-9, 2010 Sep.
Article
em Fr
| MEDLINE
| ID: mdl-20554266
ABSTRACT
Neonatal diabetes mellitus is a rare entity defined as hyperglycaemia occurring within the first 3 months of life that lasts for at least 2 weeks and requiring insulin therapy for unforeseeable duration. We report the case of a full-term female infant with permanent neonatal diabetes mellitus, stemming from consanguineous parents, born with severe intra-uterine growth retardation and birth weight of 1400 g. The patient presented on the 15th day of life a severe dehydration with a fever and ponderal loss of 14 %. The biology showed hyperglycaemia to 15 mmol/L, moderate metabolic acidosis, glucosuria and ketonuria. The diagnosis of neonatal diabetes mellitus was reserved, justifying its stake under insulin. Etiologic investigation showed a type HLA-DR4/DR8; anti-insulin antibodies were weakly positive, Langerhans islet cell and anti-GAD antibodies were negative. Abdominal magnetic resonance imaging scans, karyotype, molecular biology and chromatography of amino and organic acids did not show any abnormalities. During the first 2 years of age, the patient presented a big instability of glycaemia having required several hospitalizations. After 12 years of age, the patient is still under insulin with a satisfactory glycaemia balance and her growth is normal. Besides, she presents a microcephaly with a spastic walking. The search of neonatal diabetes mellitus must be systematic in front of any fetal hypotrophy allowing a premature coverage and a good prognosis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antígenos HLA-DR
/
Antígeno HLA-DR4
/
Diabetes Mellitus
/
Anticorpos Anti-Insulina
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Newborn
Idioma:
Fr
Ano de publicação:
2010
Tipo de documento:
Article