Conditions causing hypothermia in children by physiologic mechanism

Substrate deficiency

Hypoglycemia

Central nervous system conditions that disrupt hypothalamic and autonomic temperature regulation

Traumatic brain or spinal cord injury (including neurosurgical procedures)

Intracranial hemorrhage

Stroke

Brain tumors (eg, craniopharyngioma or astrocytoma)

Congenital brain malformations (eg, anencephaly or absence of the corpus callosum)

Familial dysautonomia

Generalized infection*

Sepsis

Meningitis

Encephalitis

Drug overdose with agents that cause central nervous system depression and vasodilation

Ethanol

Opioids

Clonidine

Benzodiazepines

Barbiturates

Antipsychotic agents (eg, chlorpromazine)

Antidepressants (eg, amitriptyline)

Endocrine or metabolic diseases that impair energy utilization or basal metabolic rate

Adrenal insufficiency

Hypothyroidism

Hypoparathyroidism

Hypopituitarism

Diabetes mellitus

Menkes disease (Menkes kinky hair syndrome)

Organic acidemias

Aminoacidemias

Increased insensible losses due to disruption of skin

Burns

Epidermolysis bullosa and other weeping dermatoses

Decreased calorie intake with decreased energy production and loss of insulating subcutaneous fat

Malnutrition

Anorexia nervosa

Other

Hyponatremia (eg, water intoxication)

Episodic spontaneous hypothermia with hyperhidrosis^¶

Child abuse and maltreatment

* Hypothermia is most frequently described in septic young infants or neonates, especially those with herpes simplex virus infection and in patients with Gram negative sepsis.
¶ Episodic spontaneous hypothermia with hyperhidrosis is a rare syndrome that is notable for hypothermia, diaphoresis, absence of shivering, and pallor without evidence of central nervous system abnormality or endocrinopathy. In addition to supportive care, episodes may respond to or be prevented by cyproheptadine.

Data from:

Corneli HM. Accidental hypothermia. J Pediatr 1992; 120:671.
Tunnessen WW, Roberts KB. Hypothermia. In: Signs and Symptoms in Pediatrics, 3rd edition, Lippincott, Williams & Wilkins, Philadelphia 1999. p.8.
Greenberg RA, Rittichier KK. Pediatric nonenvironmental hypothermia presenting to the emergency department: Episodic spontaneous hypothermia with hyperhidrosis. Pediatr Emerg Care 2003; 19:32.

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Conditions causing hypothermia in children by physiologic mechanism