Metabolism
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Fasting hypoglycaemia in an infant - and poor exercise tolerance in two brothers
LR is a 16 month old baby, who was born at term after an uneventful pregnancy. Until she was 15 months old she had been fed every 3 - 4 hours, and never slept though the night, but woke every 3 - 4 hours, demanding to be fed.
At 15 months of age she slept through the night for the first time, and was found at 6 am in a generalised tonic-clonic seizure, which might suggest epilepsy. On admission to hospital a blood sample was taken; her plasma glucose was 1.5 mmol /L (the reference range for a fasting infant is 3.9 - 6.1 mmol /L), and a urine dipstick test showed the presence of a high concentration of ketone bodies.