Repaglinide-induced factitious hypoglycemia.
We report the first case of repaglinide-induced factitious hypoglycemia in a young male. This case posed a challenging diagnostic dilemma because commercial assays for repaglinide are not available. Furthermore, the patient had a series of positive diagnostic tests such as high proinsulin and localizing intra-arterial calcium stimulation suggestive of insulinoma. This case, again, demonstrates the importance of pure clinical judgment in the face of often-conflicting laboratory data in making a correct diagnosis and the requirement of definitive data for an appropriate therapeutic resolution.
Hirshberg
B
B
Division of Intramural Research, National Institute of Diabetes, Digestive and Kidney Diseases, W. G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
Skarulis
M C
MC
Pucino
F
F
Csako
G
G
Brennan
R
R
Gorden
P
P
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002219:Carbamates / Q000506:poisoning*; D003937:Diagnosis, Differential; D005215:Fasting; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000506:poisoning*; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D001523:Mental Disorders; D010880:Piperidines / Q000506:poisoning*; D011041:Poisoning / Q000097:blood / Q000175:diagnosis*
D001786:Blood Glucose; D002219:Carbamates; D007004:Hypoglycemic Agents; D007328:Insulin; D010880:Piperidines; C072379:repaglinide