{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:42:22Z","timestamp":1784698942865,"version":"3.55.0"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2024-0365_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Congenital syphilis can cause severe morbidities such as hydrops fetalis, preterm birth, low birth weight, hepatosplenomegaly, pneumonia, hypoglycemia, etc., and mortality. Despite hypoglycemia being reported in congenital syphilis and hyperinsulinism, only one case was described. In this article, we aimed to present a newborn with congenital syphilis born to a syphilitic mother who was diagnosed with persistent hyperinsulinemic hypoglycemia with a focal lesion during follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0365_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>A female patient was born with a weight of 2,450\u202fg in the 32<jats:sup>+3rd<\/jats:sup> week of pregnancy from a 30-year-old syphilitic mother who had pleural effusion and ascites, cholestasis, thrombocytopenia, and anemia at birth. Hypoglycemia was detected on the 10th day of the patient\u2019s follow-up (47\u202fmg\/dL). The patient was unresponsive to diazoxide, and octreotide, nifedipine, and glucagon treatments were started gradually. No variants were detected in the HH gene panel, but a focal pancreatic head lesion was\u00a0detected in the pancreatic head in fluorine-18 L-3,4 dihydroxyphenylalanine positron emission tomography-computed tomography. Focal lesionectomy was recommended for the patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0365_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this article, we present a neonate with severe early congenital syphilis and focal pancreatic lesions with persistent hyperinsulinemic hypoglycemia unresponsive to diazoxide. Although hypoglycemia can be seen in congenital syphilis and has been reported before, hypoglycemia associated with hyperinsulinism is very rare; only a few patients have been presented, and a focal pancreatic lesion has not been previously reported. The pathology is unknown, but pancreatitis may cause this entity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2024-0365","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T17:52:12Z","timestamp":1732729932000},"page":"79-81","source":"Crossref","is-referenced-by-count":2,"title":["Persistent hypoglycemia in congenital syphilis: hyperinsulinemic hypoglycemia with a focal pancreatic lesion"],"prefix":"10.1515","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0825-8652","authenticated-orcid":false,"given":"Mehmet","family":"Akyar","sequence":"first","affiliation":[{"name":"Department of Pediatrics , University of Health Sciences, Bursa Yuksek \u0130htisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3298-066X","authenticated-orcid":false,"given":"\u0130pek","family":"Guney Varal","sequence":"additional","affiliation":[{"name":"Department of Neonatology , University of Health Sciences, Bursa Yuksek \u0130htisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-3948","authenticated-orcid":false,"given":"Gaffari","family":"Tun\u00e7","sequence":"additional","affiliation":[{"name":"Department of Neonatology , University of Health Sciences, Bursa Yuksek \u0130htisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0864-4244","authenticated-orcid":false,"given":"Ay\u015fe","family":"\u00d6ren","sequence":"additional","affiliation":[{"name":"Department of Neonatology , University of Health Sciences, Bursa Yuksek \u0130htisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5657-4260","authenticated-orcid":false,"given":"Yasemin","family":"Denkboy \u00d6ngen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , Bursa Uludag University, School of Medicine , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5640-9196","authenticated-orcid":false,"given":"Eren","family":"\u00c7a\u011fan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases , University of Health Sciences, Bursa Yuksek \u0130htisas Training and Research Hospital , Bursa , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2025011004321633827_j_jpem-2024-0365_ref_001","doi-asserted-by":"crossref","unstructured":"Kingston, M, French, P, Higgins, S, McQuillan, O, Sukthankar, A, Stott, C, et al.. Members of the Syphilis guidelines revision group; UK national guidelines on the management of syphilis 2015. Int J STD AIDS 2016;27:421\u201346. https:\/\/doi.org\/10.1177\/0956462415624059.","DOI":"10.1177\/0956462415624059"},{"key":"2025011004321633827_j_jpem-2024-0365_ref_002","doi-asserted-by":"crossref","unstructured":"Koliou, M, Chatzicharalampous, E, Charalambous, M, Aristeidou, K. Congenital syphilis as the cause of multiple bone fractures in a young infant case report. BMC Pediatr 2022;22:728. https:\/\/doi.org\/10.1186\/s12887-022-03789-y.","DOI":"10.1186\/s12887-022-03789-y"},{"key":"2025011004321633827_j_jpem-2024-0365_ref_003","doi-asserted-by":"crossref","unstructured":"G\u03cbemes, M, Rahman, SA, Kapoor, RR, Flanagan, S, Houghton, JAL, Misra, S, et al.. Hyperinsulinemic hypoglycemia in children and adolescents: recent advances in understanding of pathophysiology and management. 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