Pseudoinsulinoma syndrome from inadvertent tolazamide ingestion.
A 70-year-old woman with rheumatoid arthritis presented with fasting hypoglycemia, inappropriately elevated insulin and C-peptide levels, and negative insulin antibodies, all compatible with the diagnosis of an insulinoma. However, results of a 72-hour fast were subsequently negative. Medication identification revealed that the patient had been taking tolazamide (Tolinase; The Upjohn Company, Kalamazoo, Michigan) instead of tolmetin (Tolectin; McNeil Laboratories, Inc., Fort Washington, Pennsylvania).
D007516:Adenoma, Islet Cell / Q000175:diagnosis*; D000368:Aged; D005260:Female; D006801:Humans; D008508:Medication Errors; D010595:Pharmacists; D014042:Tolazamide / Q000008:administration & dosage / Q000009:adverse effects*; D014046:Tolmetin
D014042:Tolazamide; D014046:Tolmetin