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5 week old infant being treated for hyperinsulinism seen in ER with scalp discoloration

skaushik
in Metabolic disorders

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5 wk old infant came to ER with scalp discoloration (grayish) for 2 days. Baby was treated soon after birth for persistent hypoglycemia (in another hospital) and diagnosed as hyperinsulinism. Infant was sent home on po hydrochlorthiazide and diazoxide. Exam showed active, alert baby. Grayish area of discoloration covering most of scalp. No edema. BMP showed Na 133 K 7.8 (heelstick). Rest normal. CBC normal.

What is the cause of this discoloration? Can this be acanthosis nigricans though i have never seen it this early in life? What other things should one look for?

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https://99nicu.org/forums/topic/1063-5-week-old-infant-being-treated-for-hyperinsulinism-seen-in-er-with-scalp-discoloration/
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