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CASE REPORT
Dilemma of diagnosing sulphonylurea overdose in children: deliberations and considerations before reaching a diagnosis
  1. Jaya Sujatha Gopal-Kothandapani1,2,
  2. Katherine P Wright3,
  3. Sivagamy Sithambaram2,4,
  4. Anuja Natarajan5
  1. 1 Department of Paediatrics and Endocrinology, University of Sheffield, Sheffield, UK
  2. 2 Department of Paediatrics, Bassetlaw District General Hospital, Worksop, UK
  3. 3 Department of Clinical Laboratory Sciences, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK
  4. 4 Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
  5. 5 Department of Paediatrics, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK
  1. Correspondence to Dr Jaya Sujatha Gopal-Kothandapani, sujatha.gopal{at}nhs.net

Summary

A 15-year-old non-diabetic Caucasian girl presented with sudden onset of seizures, unrecordable blood glucose readings and acute renal failure. She denied any medication ingestion and no other precipitating factors were encountered for this acute presentation. She was treated with intravenous glucose infusion and hydrocortisone injection. Investigations showed a non-ketotic hypoglycaemia with high C-peptide and insulin levels. It took several days and multiple investigations to establish the exact cause of her persistent hypoglycaemia before it was concluded to be secondary to gliclazide overdose in a suicide attempt by the young girl. She made a complete recovery in a week with no apparent lasting neurological or renal impairment.

  • Endocrine System
  • Paediatrics (drugs And Medicines)
  • Renal System
  • Psychiatry (drugs And Medicines)
  • Drugs: Endocrine System

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Footnotes

  • Contributors JSGK drafted and edited the case report and discussion. SS assisted in summarising the case report. KPW and AN critically analysed the report and discussion. AN approved the final draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.