# Secondary Hirata Syndrome in a Neonate: Practical Approach and Management

## TL;DR

This paper presents the first reported case of a neonate with secondary Hirata syndrome, a rare condition causing hypoglycemia due to insulin autoantibodies passed from the mother.

## Contribution

The novelty lies in documenting the first neonatal case of secondary insulin autoimmune syndrome and discussing its management.

## Key findings

- A neonate presented with hypoglycemia caused by secondary insulin autoimmune syndrome.
- Insulin autoantibodies were transferred from the mother to the fetus through the placenta.
- Management strategies for neonatal hypoglycemia due to this syndrome were discussed.

## Abstract

Hirata disease, also known as insulin autoimmune syndrome (IAS), is a rare cause of hypoglycemia, due to the presence of insulin autoantibodies (IAA) in the circulating blood. These antibodies are immunoglobulin G (IgG), making placental transfer to the fetus possible. To our knowledge, no reports of IAS have been previously described in the neonatal population. We present a case report of hypoglycemia due to a secondary IAS in a neonate and discuss the management and treatment of the disease.