Idiopathic ketotic hypoglycemia in children : An update

Idiopathic ketotic hypoglycemia (IKH ) is defined as bouts of hypoglycemia with increased blood or urine ketones that occur in certain children after prolonged fasting or during illness .IKH is divided into physiological IKH which most frequently observed in normal children with inter current acute illness and pathological IKH which are seen in children who lack counter-regulatory hormones or in children with some metabolic disease or Silver-Russell syndrome .The typical patient is a young child between the ages of 10 months and 6 years. Episodes nearly always occur in the morning after an overnight. Symptoms include those of neuroglycopenia, ketosis, or both. IKH may be diagnosed after the ruling out various metabolic and hormonal condition associated with KH . Providing sufficient amounts of carbohydrates and protein, avoidance of prolonged fasting, increased frequency of feedings are main lines of treatment of IKH . It is crucial to understand the pathogenesis of IKH and to distinguish physiological IKH from pathological IKH. In this mini-review, we present a brief review of IKH as regard definition, types, clinical presentation, , diagnosis and therapeutic approach of IKH in children.