Pulmonary Hypertension Following Increased Dosing of Diazoxide in an Infant

Int Heart J. 2020 Sep 29;61(5):1084-1087. doi: 10.1536/ihj.20-024. Epub 2020 Sep 12.


Diazoxide, a drug used to treat hyperinsulinemic hypoglycemia (HH), is associated with pulmonary hypertension (PH), as reported by the US Food and Drug Administration. However, no report has detailed the association between diazoxide dose and PH development. We report a case of an infant with HH, subsequently complicated by diazoxide-induced PH. When diazoxide was introduced, PH did not appear initially, but it developed during increased dosing. We monitored PH via regular echocardiography examinations. PH gradually improved with tapering of the diazoxide dose and disappeared after drug discontinuation. Our case suggests a diazoxide dose threshold might induce PH. Therefore, close echocardiography examinations should accompany diazoxide treatment.

Keywords: Adverse effect; Echocardiography; Hyperinsulinemic hyperglycemia; Potassium ion channel; Ventricular pressure.

Publication types

  • Case Reports

MeSH terms

  • Atrial Natriuretic Factor / blood
  • Beckwith-Wiedemann Syndrome / complications
  • Beckwith-Wiedemann Syndrome / diagnosis*
  • Cardiac Catheterization
  • Congenital Hyperinsulinism / drug therapy*
  • Congenital Hyperinsulinism / etiology
  • Deprescriptions
  • Diazoxide / administration & dosage
  • Diazoxide / adverse effects*
  • Diuretics / therapeutic use
  • Dose-Response Relationship, Drug
  • Echocardiography
  • Electrocardiography
  • Humans
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / chemically induced*
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / drug therapy
  • Infant
  • Infant, Newborn
  • Male
  • Natriuretic Peptide, Brain / blood
  • Sildenafil Citrate / therapeutic use
  • Vasodilator Agents / therapeutic use


  • Diuretics
  • Vasodilator Agents
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor
  • Sildenafil Citrate
  • Diazoxide