Abstract
Hyperinsulinemic hypoglycemia associated with trimethoprim-sulfamethoxazole (TMP-SMX) has generally been reported in adults who had renal impairment or in patients with AIDS using high dose TMP-SMX. We present a 5 month-old infant with immunodeficiency due to major histocompatibility complex class II expression defect, developing hypoglycemic convulsion on the third day of high dose TMP-SMX administration. High insulin and C-peptide levels were documented at the time of hypoglycemia. To overcome hypoglycemia while TMP-SMX tapered off, diazoxide was administered which resolved hypoglycemia in 2 months.
MeSH terms
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Blood Glucose / metabolism
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C-Peptide / blood
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Diazoxide / therapeutic use*
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Drug Administration Schedule
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Female
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Gene Expression
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Genes, MHC Class II / genetics
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Glucose / administration & dosage
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Glucose / therapeutic use
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Histocompatibility Antigens Class II / immunology*
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Hospitalization
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Humans
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Hyperinsulinism / chemically induced
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Hyperinsulinism / complications
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Hyperinsulinism / drug therapy
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Hypoglycemia / chemically induced*
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Hypoglycemia / complications
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Hypoglycemia / drug therapy
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Immunologic Deficiency Syndromes / complications*
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Immunologic Deficiency Syndromes / diagnosis*
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Immunologic Deficiency Syndromes / genetics
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Infant
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Infusions, Intravenous
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Pneumonia / diagnosis
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Pneumonia / drug therapy
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Seizures / chemically induced
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Seizures / complications
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Seizures / drug therapy
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Time Factors
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Treatment Outcome
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Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects*
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
Substances
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Blood Glucose
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C-Peptide
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Histocompatibility Antigens Class II
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Trimethoprim, Sulfamethoxazole Drug Combination
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Glucose
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Diazoxide