What is the most likely cause of hyperinsulinism in a newborn: (a) nesidioblastosis, (b) glycogen storage disease, (c) benign insulinoma, or (d) malignant insulinoma?

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Differential Diagnosis for Hyperinsulinism in a Newborn

  • Single most likely diagnosis
    • (a) nesidioblastosis: This is a rare condition characterized by an abnormal overgrowth of pancreatic islet cells, leading to excessive insulin production. It is a common cause of hyperinsulinism in newborns, making it the most likely diagnosis.
  • Other Likely diagnoses
    • (b) glycogen storage disease: Certain types of glycogen storage diseases, such as Beckwith-Wiedemann syndrome, can cause hyperinsulinism in newborns due to abnormal glucose metabolism.
    • (c) benign insulinoma: Although rare in newborns, a benign insulinoma can cause hyperinsulinism due to autonomous insulin production.
  • Do Not Miss
    • (d) malignant insulinoma: Although extremely rare in newborns, a malignant insulinoma can have severe consequences if left untreated, making it essential to consider in the differential diagnosis.
    • Other conditions that may not be directly related to the options but can cause hyperinsulinism, such as congenital hyperinsulinism due to genetic mutations (e.g., ABCC8, KCNJ11), beckwith-wiedemann syndrome, or pancreatic islet cell hyperplasia.
  • Rare diagnoses
    • Other rare genetic disorders, such as glutamate dehydrogenase deficiency or short-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, can also cause hyperinsulinism in newborns.
    • Insulin-like growth factor-2 (IGF-2) overproduction, which can be associated with certain genetic conditions, such as Beckwith-Wiedemann syndrome.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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