Factitious hypoglycemia : "a never-ending story"?
(2018) Annales de Biologie Clinique — Vol. 76, n° 4, p. 439-444 (2018)
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- Abstract
- Our team of diabetologist is challenged by the case of a 41 year-old woman with recurrent hypoglycaemic episodes. Her clinical background was complex with, among others, a neuroendocrine tumor, a nonalcoholic steatohepatitis and an adrenal insufficiency; these conditions require the exploration of several potential causes. After excluding an endogenous etiology, a factitious hypoglycemia was quicky suspected by clinicians. However, several venous samples showed normal insulinemia and a moderately decreased C-peptide. After multidisciplinary team discussion and facing a strong clinical suspicion, samples were sent to another laboratory to confirm the insulin results. Substantially supratherapeutics insulin concentrations were highlighted. This confirms the previous suspicion of surreptitious insulin administration with a recombinant form unrecognized by our routinely used analyzer. This observation leads us to briefly discuss the lack of cross-reactivities observed with many different insulin assays.
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Citations
Bayart, J.-L., Closset, M., Coulon, A., Furnica, R.-M., & Gruson, D. (2018). Factitious hypoglycemia : “a never-ending story”? Annales de Biologie Clinique, 76(4), 439-444. https://doi.org/10.1684/abc.2018.1362 (Original work published 2018)