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Hypoglycemia in PregnancyOccurrence due to Adrenocorticotropic Hormone and Growth Hormone Deficiency
LTC Robert C. Smallridge, MC;
Dominic F. Corrigan, MD;
LTC Albert M. Thomason, MC;
MAJ Peter W. Blue, MC
Arch Intern Med. 1980;140(4):564-565.
Abstract
• Severe symptomatic hypoglycemia (serum glucose level, 24 mg/dL) developed in a 23-year-old, 147.3-cm-tall woman during her late second and early third trimesters of pregnancy. Endocrine studies disclosed insulin levels < 2 µU/mL; growth hormone level < 3 ng/mL; and cortisol level < 1 µg/dL. Hydrocortisone therapy corrected her hypoglycemia, and she was delivered of a healthy female infant. Postpartum, her evaluation included normal thyroid function studies, a normal thyroidstimulating hormone response to protirelin (thyrotropin-releasing hormone), normal serum and urine gonadotropin levels, normal serum prolactin, normal sella turcica tomograms, and a normal EMI brain scan. Urine 17-hydroxycorticosteroids increased during a four-day cosyntropin infusion, but failed to rise after metyrapone administration. The growth hormone level failed to rise after stimulation with levodopa and propranolol administration. The patient was believed to have idiopathic partial hypopituitarism, with hypoglycemia being due to adrenocorticotropic hormone (ACTH) and growth hormone deficiency and the drain of maternal glucose by the fetus. It is suggested that pregnant women with symptomatic hypoglycemia be treated with glucocorticoids while awaiting the results of their endocrine evaluation.
(Arch Intern Med 140:564-565, 1980)
Author Affiliations
USA; USA; USA
From the Division of Endocrinology and Clinical Investigation Service (Drs Smallridge and Corrigan), the Division of Nuclear Medicine (Dr Blue), Walter Reed Army Medical Center, Washington, DC, and Brooke Army Medical Center, San Antonio, Tex (Dr Thomason).
Footnotes
Accepted for publication Aug 20, 1979.
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.
Reprint requests to Division of Endocrinology-Metabolism, Walter Reed Army Medical Center, Washington, DC 20012 (Dr Smallridge).
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