PEDIATRICS Vol. 43 No. 2 February 1969, pp. 217-225
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HYPOGLYCEMIA AND HYPERINSULINEMIA ASSOCIATED WITH ERYTHROBLASTOSIS FETALIS

Kari O. Raivio M.D.1 and Kalle Österlund M.D.1

1 Children's Hospital and Department I of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland

In a survey of blood glucose levels in 232 erythroblastotic infants during the first 3 days of life, 12 cases of significant hypoglycemia were revealed. Most of these had a severe primary disease; the incidence of hypoglycemia was 17.8% in patients with cord hemoglobin concentrations below 10 gm per 100 ml and 1.9% in those with higher cord hemoglobin levels. The low glucose values were usually observed during the first day of life and were unassociated with recognizable symptoms. Plasma insulin levels, determined in 39 cases before age 24 hours and prior to treatment, were shown to be negatively correlated with the cord hemoglobin concentrations.

Hyperinsulinemia, directly correlated with the severity of the erythroblastosis, is postulated to be the cause of the low blood glucose levels. As another consequence of the hyperinsulinemia, a depression of the plasma free fatty acid concentrations was documented.

The mechanism of the hyperinsulinemia, the therapeutic and prognostic implications of the hypoglycemia, as well as the effect of the depression of free fatty acid levels on the bilirubin-binding capacity of serum are briefly discussed.

Submitted on July 8, 1968
Accepted on September 15, 1968




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