Mohajeri-Tehrani et al., "Factitious hypoglycemia
caused by a unique pattern of drug use: a case report," International Journal of Endocrinology and Metabolism, vol.
Diagnosis of ABCC8 Congenital Hyperinsulinism of Infancy in a 20-Year-Old Man Evaluated for Factitious Hypoglycemia
J Clin Endocrinol Metab 2017;102:345-349.
We concluded that this patient had factitious hypoglycemia, a syndrome where patients self-induce hypoglycemia to seek medical attention or assume a sick role.
* Factitious hypoglycemia is highly challenging to diagnose and manage.
* Measurement of C-peptide and free and direct insulin can help differentiate factitious hypoglycemia from other organic causes.
The differential diagnoses of hyperinsulinemic hypoglycemia include familial persistent hyperinsulinemic hypoglycemia, primary islet-cell hyperplasia, noninsulinoma pancreatogenous hypoglycemic syndrome, insulinoma, and factitious hypoglycemia
Presumed to be rare, factitious hypoglycemia
is most often seen in people without diabetes who are healthcare workers, relatives of diabetes patients, and often women.
"Factitious hypoglycemia" is confirmed when the origin of the insulin increase is demonstrated to be exogenous (suppressed plasma C-peptide immunoreactivity) or when SU drugs (or their metabolites) are found in serum or urine (9-12).
To introduce the CE method as a confirmatory method for SU identification in the cases of factitious hypoglycemia, we tried to optimize the preanalytical phase by replacing the classical liquid-liquid extraction with a solid-phase extraction (22).
Factitious hypoglycemia due to surreptitious administration of insulin: diagnosis, treatment and long-term follow-up.
Sulfonylurea-induced factitious hypoglycemia in a non-diabetic nurse.