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Infants treated with diazoxide for hyperinsulinism show high prevalence of adverse events

29 Nov 2018

Pulmonary hypertension (PH) is associated with underlying risk factors in children with congenital hyperinsulinism (HI) treated with diazoxide, reports a study. Other adverse events, however, do not show any identifiable risk profile.

“The relatively high prevalence of neutropaenia, thrombocytopaenia and hyperuricaemia suggests the value in proactively screening for these side effects in children treated with diazoxide,” the authors said.

A total of 295 patients (median age at diazoxide initiation, 29 days; interquartile range, 10–142 days; 129 females; n=226 available start dates) were included, of which 2.4 percent presented with PH following diazoxide initiation.

PH (p=0.003) or oedema (p=0.002) in children was associated with earlier gestational age at birth and with potential risk factors for PH, including respiratory failure and structural heart disease (p<0.0001 and p=0.005, respectively). Other adverse events were neutropaenia (15.6 percent), hyperuricaemia (5.0 percent) and thrombocytopaenia (4.7 percent).

“Diazoxide, the only US Food and Drug Administration–approved drug to treat hyperinsulinaemic hypoglycaemia, has been associated with several adverse events, which has raised concerns about the safety of this drug. Existing reports are limited to small studies and case reports,” the authors noted.

In this retrospective study, children and infants with laboratory-confirmed diagnosis of HI treated with diazoxide between 2003 and 2014 were included. The authors determined the prevalence of PH, oedema, neutropaenia, thrombocytopaenia and hyperuricaemia. They identified potential risk factors using tests of association and logistic regression.

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Most Read Articles
14 Mar 2017
Levels of serum proteins, particularly the leucine-rich alpha-2-glycoprotein 1 (LRG1), can be used as biomarkers for the diagnosis of Kawasaki disease (KD) and accurate identification of its phases, a new proteomic study reveals.
01 Sep 2016
Salmeterol/fluticasone exhibits comparable serious asthma-related event risk with that of fluticasone alone in children with asthma, a prospective study shows.
28 Jan 2019
High-frequency social media interactions, such as email and instant messaging, in the hour before bed may lead to insufficient sleep among female children and adolescents, a recent study reports.