Evidence map›Paper›PMID 41655234›Full record

ArticleThe Journal of clinical endocrinology and metabolism2026

Determinants of hyperinsulinism severity in children with Beckwith-Wiedemann syndrome.

Andrew M George, Aravind Viswanathan, Jonathan H Sussman, Evan R Hathaway, Abigail Casalnova, Salima Nesbitt, Kara E Boodhansingh, Nicole M Stewart, Heather J McKnight, Katherine Lord and 5 more

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Determinants of hyperinsulinism severity in children with Beckwith-Wiedemann syndrome.The Journal of clinical endocrinology and metabolism · 2026
    Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Andrew M GeorgeDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.ORCID 0000-0001-6661-3924
Aravind ViswanathanDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.ORCID 0009-0001-8127-3419
Jonathan H SussmanPerelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.ORCID 0000-0002-3057-3550
Evan R HathawayDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Abigail CasalnovaDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Salima NesbittDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Kara E BoodhansinghCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Nicole M StewartCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Heather J McKnightCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Katherine LordCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Diva D De LeónCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Charles A StanleyCongenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
N Scott AdzickDepartment of Surgery, The Children's Hospital of Philadelphia and the Perelman School of Medicine, Philadelphia, PA 19104, USA.
Arupa GangulyDepartment of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.ORCID 0000-0003-4527-3216
Jennifer M KalishDivision of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.ORCID 0000-0003-1500-9713

Funding

Beckwith-Wiedemann Syndrome ResearchVictoria Fertitta Fund
6 · The paper itself

Abstract

contextCongenital hyperinsulinism (HI) is a serious clinical feature of Beckwith-Wiedemann syndrome (BWS) causing severe hypoglycemia. The relationship between BWS genotypes and HI severity is not well understood.

objectiveInvestigate the relationship between molecular determinants of patients with BWS and HI with measures of HI severity.

methodsThis retrospective cohort study included 85 children from 2009-2024, all patients evaluated at single, tertiary care center. BWS genotype frequency included 41 children with pUPD11, 24 with IC2 LOM, 8 with 11p15 chromosomal anomalies, 6 with GWpUPD, 4 with IC1 GOM, and 2 with CDKN1C. Retrospectively reviewed interventions included maximum glucose infusion rate (max GIR), diazoxide responsiveness, and surgery. Primary outcome was association between BWS genotypes and measures of HI severity. Secondary outcomes included the relationship between pUPD11 length and presence of KATP variants with diazoxide responsiveness and surgical need.

resultsSignificant differences presented among genotypes in max GIR (P = .004), enteral dextrose requirements (P = .029), and pancreatectomy (P = .012). Most patients with IC2 LOM, IC1 GOM or CDKN1C were diazoxide responsive and did not require surgery. Patients with pUPD11 were more likely to be diazoxide unresponsive and to require surgery, especially if pUPD11 length extended into the KATP gene region and if a pathogenic variant in the ABCC8 or KCNJ11 was present.

conclusionPatients with pUPD11 experience more severe HI, while patients with IC2 LOM, IC1 GOM, and CDKN1C exhibit milder disease. Based on our findings, we designed a genetic testing algorithm to guide clinical management.

Indexed as

Beckwith-Wiedemann SyndromeCongenital HyperinsulinismChild, PreschoolDiazoxideFemaleGenotypeHumansInfantInfant, NewbornMalePancreatectomyRetrospective StudiesSeverity of Illness IndexDiazoxideBeckwith-Wiedemann syndromediazoxidehyperinsulinismhypoglycemiainsulinpancreatectomy

Identifiers

PMID41655234
PMCPMC13271782

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.