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Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2346156.078    [Accepted] Published online January 29, 2024.
Idiopathic ketotic hypoglycemia in children : An update
Kotb Abbass Metwalley1  , Hekma Saad Farghaly1
1Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
2Professor Pediatrics ,Pediatric Department , Faculty of Medicine,Assiut University, Assiut, Egypt
Address for correspondence:  Kotb Abbass Metwalley
Email: kotb72@gmail.com
Received: July 25, 2023   Revised: September 6, 2023   Accepted: October 4, 2023
Abstract
Idiopathic ketotic hypoglycemia (IKH ) is defined as bouts of hypoglycemia with increased blood or urine ketones that occur in certain children after prolonged fasting or during illness .IKH is divided into physiological IKH which most frequently observed in normal children with inter current acute illness and pathological IKH which are seen in children who lack counter-regulatory hormones or in children with some metabolic disease or Silver–Russell syndrome .The typical patient is a young child between the ages of 10 months and 6 years. Episodes nearly always occur in the morning after an overnight. Symptoms include those of neuroglycopenia, ketosis, or both. IKH may be diagnosed after the ruling out various metabolic and hormonal condition associated with KH . Providing sufficient amounts of carbohydrates and protein, avoidance of prolonged fasting, increased frequency of feedings are main lines of treatment of IKH . It is crucial to understand the pathogenesis of IKH and to distinguish physiological IKH from pathological IKH. In this mini-review, we present a brief review of IKH as regard definition, types, clinical presentation, , diagnosis and therapeutic approach of IKH in children.
Keywords: Idiopathic ketotic hypoglycemia , ketonuria , ketonemia, prolonged fasting


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