Diploid/tetraploid mosaicism in the offspring of a 46XX/47XXX mosaic mother

A 10½-year-old boy with an IQ of 71, short stature, and isolated growth hormone deficiency was found to have diploid/tetraploid mosaicism. He was born to a 46xx/47xxx mosaic mother. The mother was found to be moderately mentally retarded but showed no other abnormalities. A review of literature pertinent to this case is presented.

Diabetes and neutrophil chemotaxis

The chemotaxis of PMN cells from adult and juvenile diabetics and proper control subjects was found to be comparable. Similarly, chemotactic activity generated from diabetic sera was not different from the activity generated from the normal sera.

Insulin and sodium bicarbonate treatment in diabetic ketoacidosis in children

Nineteen patients, nine males and ten females had 24 episodes of diabetic ketoacidosis. Infection was the precipitating factor in the development of ketoacidosis. Recovery of ketoacidosis occurred with 0.7 units of crystalline insulin per kg of body weight. The insulin requirement is less than the generally recommended dose. Hypoglycemia, hypokalemia, and alkalosis were not developed in our children. Ketoacidosis was adequately corrected by 2.5 mEq of sodium bicarbonate per kg of body weight.

Maximum stimulation of insulin secretion in children with chemical diabetes and obesity

The response of plasma insulin concentration to an oral glucose tolerance test (OGTT) and to the maximum stimulatory effect obtained with administration of glucose, glucagon and tolbutamide was studied in 24 siblings of diabetic children and in ten obese children. Five siblings of patients with diabetes sound to have chemical diabetes had hyperinsulinism during the OGTT. Serum insulin concentrations during the maximum stimulation of the beta cells in the children with chemical diabetes, although diminished at 15 minutes, were considered not significantly different from controls. Obese children had hyperinsulinism during the OGTT and the maximum stimulation of the beta cell. The data suggest that hyperinsulinism may precede or accompany carbohydrate intolerance in siblings of diabetic children.

Permanent panhypopituitarism associated with maternal deprivation

A 15-year-old boy with a history of maternal deprivation since age 2 years had severe growth retardation and panhypopituitarism. After one year in an appropriate foster home, there were no changes in his growth rate and pituitary function. This appears to be a case in which panhypopituitarism, probably secondary to maternal deprivation, was not corrected after placement in an appropriate environment. The normal increase in the concentration of serum thyroid stimulating hormone after the administration of protirelin (Thypinone) suggested that the primary abnormality was in the hypothalamic centers controlling the release of the pituitary hormones. Knowledge of the possibility of permanent panhypopituitarism secondary to maternal deprivation might encourage careful follow-up of these patients after placement.