Factitious hypoglycemia

摘要: Abstract The differential diagnosis of "spontaneous" hypoglycemia should always include the possibility surreptitious self-administration insulin or oral hypoglycemic agents, especially in diabetic patients, nurses anyone else familiar with their effects. We describe a patient presenting episodes who claimed not to have taken for approximately twelve years. His long history intermittent symptoms, results his glucose and tolbutamide tolerance tests limited peak response were all against pancreatic islet cell adenoma. presence significant titer insulin-binding antibodies plasma heightened our suspicion factitious hypoglycemia; this was further confirmed by finding 131 I-Hippuran ® urine following addition substance bottle found clothing. between insulinoma is discussed, as are methods confirming latter diagnosis.