Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-11T03:17:35.457Z Has data issue: false hasContentIssue false

Recurrent hypoglycaemia in a toddler on β-blocker therapy

Published online by Cambridge University Press:  08 January 2018

Véronique Pépin
Affiliation:
Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Nancy Gagné
Affiliation:
Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Diane Rottembourg*
Affiliation:
Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
*
Correspondence to: D. Rottembourg, Department of Pediatrics, Centre Hospitalier Universitaire de Sherbrooke, 3001 12e av NORD, Sherbrooke, Quebec, Canada, J1H 5N4. Tel: 1 819 346 1110; Fax: 1 819 564 5398; E-mail: diane.rottembourg@usherbrooke.ca

Abstract

Hypoglycaemia is a well-known side effect of Propranolol. We described the case of a child presenting severe and recurrent Propranolol-induced hypoglycaemia. Those episodes were not related to prolonged fasting and were associated with only mild ketosis. Thus, therapy with β blockers may not only aggravate classical ketotic hypoglycaemia but also interfere with glucose metabolism.

Type
Brief Report
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Holland, KE, Frieden, IJ, Frommelt, PC, Mancini, AJ, Wyatt, D, Drolet, BA. Hypoglycemia in children taking propranolol for the treatment of infantile hemangioma. Arch Dermatol 2010; 146: 775778.Google Scholar
2. Poterucha, JT, Bos, JM, Cannon, BC, Ackerman, MJ. Frequency and severity of hypoglycemia in children with beta-blocker–treated long QT syndrome. Heart Rhythm 2015; 12: 18151819.CrossRefGoogle ScholarPubMed
3. Chavez, H, Ozolins, D, Losek, JD. Hypoglycemia and propranolol in pediatric behavioral disorders. Pediatrics 1999; 103: 12901291.Google Scholar
4. Hussain, T, Greenhalgh, K, McLeod, KA. Hypoglycaemic syncope in children secondary to beta-blockers. Arch Dis Childhood 2009; 94: 968969.Google Scholar
5. Barth, E, Albuszies, G, Baumgart, K, et al. Glucose metabolism and catecholamines. Crit Care Med 2007; 35: S50818.Google Scholar
6. Sprague, JE, Arbeláez, AM. Glucose counterregulatory responses to hypoglycemia. Pediatr Endocrinol Rev 2011; 9: 463473.Google Scholar
7. Schluter, KJ, Aellig, WH, Petersen, KG, Rieband, HC, Wehrli, A, Kerp, L. The influence of beta‐adrenoceptor blocking drugs with and without intrinsic sympathomimetic activity on the hormonal responses to hypo‐and hyperglycaemia. Br J Clin Pharmacol 1982; 13 (Suppl 2): 407–417.Google Scholar
8. Lawrence, AM, Ajlouni, K, Hagen, TC. Chronic propranolol administration impairs glucagon release during insulin-induced hypoglycemia in normal man. J Clin Endocrinol Metab 1984; 59: 622624.Google Scholar
9. Huidekoper, HH, Duran, M, Turkenburg, M, Ackermans, MT, Sauerwein, HP, Wijburg, FA. Fasting adaptation in idiopathic ketotic hypoglycemia: a mismatch between glucose production and demand. Eur J Pediatr 2008; 167: 859865.Google Scholar
10. Popp, DA, Shah, SD, Cryer, PE. Role of epinephrine-mediated beta-adrenergic mechanisms in hypoglycemic glucose counterregulation and posthypoglycemic hyperglycemia in insulin-dependent diabetes mellitus. J Clin Invest 1982; 69: 315326.Google Scholar