Treatable Intellectual Disability

Hyperinsulinism Hyperammonemia Syndrome

DIAGNOSIS

Gene
GLUD1 (AR)

Diagnostic Test
GDH Gene Sequencing (& Ammonia, Glucose, Insulin)

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SIGNS & SYMPTOMS

Neurological
Epilepsy

Non-Neurological
- - -

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THERAPY

Treatment
Diazoxide

Level of Evidence
4-5

Clinical Practice
Standard of Care

Treatment Effect
Stabilizes clinical deterioration



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Hyperinsulinism Hyperammonemia Syndrome

Hyperinsulinism Hyperammonemia Syndrome

The hyperinsulinism/hyperammonemia (HI/HA) syndrome is a form of congenital hyperinsulinism in which affected children have recurrent symptomatic hypoglycemia together with asymptomatic, persistent elevations of plasma ammonium levels. The disorder is caused by dominant mutations of the mitochondrial enzyme, glutamate dehydrogenase (GDH), that impair sensitivity to the allosteric inhibitor, GTP. Patients have clinical evidence of hyperinsulinism, including attacks of symptomatic hypoglycemia. Developmental delay and intellectual disability occur as sequelae of recurrent uncontrolled hypoglycemic attacks.

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