Hypoglycemia causes: Difference between revisions

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| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Gastrojejunostomy]], [[Postgastrectomy syndrome]], [[Pyloroplasty]], [[Reye syndrome]]
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| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute meningitis]], [[Malaria (malignant tertian)]], [[Sepsis]], [[Visceral leishmaniasis]]
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| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Autonomic dystonia]], [[Autonomic neuropathy]], [[Elevated vagal tone]]
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| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Coenzyme Q cytochrome c reductase deficiency]], [[Deficiency in enzymes of fat oxidation]], [[Fructose intolerance]], [[Galactosemia]], [[Glycogen debranching deficiency]], [[Hypoketonemic hypoglycemia]], [[Ketotic hypoglycemia of infancy]], [[Mcquarrie type infantile idiopathic hypoglycemia]], [[Organic acidemia]], [[Phosphoenolpyruvate carboxykinase (PEPCK) deficiency]], [[Urea cycle disorder]]
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Revision as of 18:12, 19 November 2012

Hypoglycemia Microchapters

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Overview

Historical Perspective

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Differentiating Hypoglycemia from other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

Common Causes

Hypoglycemia in newborn infants

Hypoglycemia is a common problem in critically ill or extremely low birthweight infants. If not due to maternal hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge.

Hypoglycemia in young children

Single episodes of hypoglycemia due to gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism

Hypoglycemia in older children and young adults

By far the most common cause of severe hypoglycemia in this age range is insulin injected for type 1 diabetes. Circumstances should provide clues fairly quickly for the new diseases causing severe hypoglycemia. All of the congenital metabolic defects, congenital forms of hyperinsulinism, and congenital hypopituitarism are likely to have already been diagnosed or are unlikely to start causing new hypoglycemia at this age. Body mass is large enough to make starvation hypoglycemia and idiopathic ketotic hypoglycemia quite uncommon. Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia.

Hypoglycemia in older adults

The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults.

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning 1,1-Dichloroethene, Ackee fruit , Jamaican vomiting sickness, Systemic monochloroacetate poisoning
Dermatologic No underlying causes
Drug Side Effect Acetohexamide, Amprenavir, Chloramphenicol, Chlorpromazine, Chlorpropamide, Cibenzoline, Clove, Ethanol, Ethionamide, Fluorodeoxyglucose, Gatifloxacin, Ginseng, Glibenclamide, Gliclazide, Glimepiride, Glipizide, Gliquidone, Glisolamide, Glisoxepide, Insulin, Insulin like growth factor , Lanreotide, Levomepromazine, Mitiglinide, Nateglinide, Pazopanib, Pentamidine, Perazine, Pipothiazine, Pramlintide, Quinine, Repaglinide, Ritonavir, Saquinavir, Somatostatin, Sulfamethoxazole, Temafloxacin, Tolazamide, Tolbutamide, Trimethoprim
Ear Nose Throat No underlying causes
Endocrine Addison's disease, Adrenal cortex insufficiency, Adrenal insufficiency, Beginning stages of diabetes, Glucagon deficiency, Hypopituitarism, Hypothyroidism, Multiple endocrine neoplasia , Myxedema coma, Timme syndrome
Environmental No underlying causes
Gastroenterologic Acute fatty liver of pregnancy, Acute liver failure, Cirrhosis, Diabetic gastroparesis, Diarrhea, Dumping syndrome, Functioning pancreatic endocrine tumor, Gastric dumping syndrome, Hepatic congestion, Hepatic failure, Idiopathic postprandial syndrome, Insulinoma, Liver cancer, Malabsorption, Maldigestion, Reactive hypoglycemia, Severe hepatitis
Genetic 2-methylbutyryl-coenzyme A dehydrogenase deficiency, 3-alpha-hydroxyacyl-CoA dehydrogenase deficiency, 3-Methylcrotonyl-CoA carboxylase deficiency, ACAD9 deficiency, Alpers Syndrome, Carbohydrate-deficient glycoprotein syndrome type 1b, Carnitine palmitoyltransferase 1 deficiency, Carnitine-acylcarnitine translocase deficiency, Cleft lip palate pituitary deficiency, Dicarboxylicaminoaciduria, Dihydrolipoamide dehydrogenase deficiency, Donohue syndrome, Dopamine beta-hydroxylase deficiency, Familial glucocorticoid deficiency, Familial hyperinsulinemic hypoglycemia type 3, Familial hyperinsulinemic hypoglycemia type 5, Familial hyperinsulinemic hypoglycemia type 7, Fructose-1, 6-diphosphatase deficiency, Fructose-1-phosphate aldolase deficiency, Galactose-1-phosphate uridyltransferase deficiency, Glucose 6 phosphate dehydrogenase deficiency, Glutaric acidemia type 2, Glycogenosis type 1a, Glycogenosis type 1b, Glycogenosis type 3, Glycogenosis type 6, Glycogenosis type 9a, Glycogenosis type 9b, Glycogenosis type 9c, Glycogenosis type V, Growth hormone deficiency (congenital), Hereditary ACTH resistance, HMG-CoA lyase deficiency, Hydroxymethylglutaryl-CoA lyase deficiency, Hyperinsulinism-hyperammonemia syndrome, Laron dwarfism, Leucine-induced hypoglycaemia, Liver glycogen synthase deficiency, Long chain hydroxyacyl-CoA dehydrogenase deficiency, Malonyl-CoA decarboxylase deficiency, Maple syrup urine disease, Medium chain acyl-CoA dehydrogenase deficiency, Methylmalonic acidemia, Mitochondrial DNA depletion syndrome, hepatocerebral form, Mitochondrial trifunctional protein deficiency, Navajo neurohepatopathy, Nephroblastomatosis-fetal ascites-macrosomia-wilms tumor, Nesidioblastosis, Plasma membrane carnitine transporter deficiency, Propionyl-CoA carboxylase deficiency PCCA type, Short chain acyl-CoA dehydrogenase deficiency, Short stature-pituitary and cerebellar defects-small sella turcica, Triple A syndrome, Tyrosinaemia type 1, Very long-chain acyl-CoA dehydrogenase deficiency, Wiedemann-Beckwith syndrome, X-linked congenital adrenal hypoplasia
Hematologic No underlying causes
Iatrogenic Gastrojejunostomy, Postgastrectomy syndrome, Pyloroplasty, Reye syndrome
Infectious Disease Acute meningitis, Malaria (malignant tertian), Sepsis, Visceral leishmaniasis
Musculoskeletal / Ortho No underlying causes
Neurologic Autonomic dystonia, Autonomic neuropathy, Elevated vagal tone
Nutritional / Metabolic Coenzyme Q cytochrome c reductase deficiency, Deficiency in enzymes of fat oxidation, Fructose intolerance, Galactosemia, Glycogen debranching deficiency, Hypoketonemic hypoglycemia, Ketotic hypoglycemia of infancy, Mcquarrie type infantile idiopathic hypoglycemia, Organic acidemia, Phosphoenolpyruvate carboxykinase (PEPCK) deficiency, Urea cycle disorder
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity Acetohexamide, Amprenavir, Chloramphenicol, Chlorpromazine, Chlorpropamide, Cibenzoline, Clove, Ethanol, Ethionamide, Fluorodeoxyglucose, Gatifloxacin, Ginseng, Glibenclamide, Gliclazide, Glimepiride, Glipizide, Gliquidone, Glisolamide, Glisoxepide, Insulin, Insulin like growth factor , Lanreotide, Levomepromazine, Mitiglinide, Nateglinide, Pazopanib, Pentamidine, Perazine, Pipothiazine, Pramlintide, Quinine, Repaglinide, Ritonavir, Saquinavir, Somatostatin, Sulfamethoxazole, Temafloxacin, Tolazamide, Tolbutamide, Trimethoprim
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


References

  1. "The Hypoglycemic states - Hypoglycemia". The Hypoglycemic states. Armenian Medical Network. 2007. Text " Umesh Masharani, MB, BS, MRCP(UK) " ignored (help)

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