title: [Endogenous hyperinsulinism: two diagnostic challenges].
abstract: Hypoglycemia in apparently healthy adults is a rare finding in clinical practice requiring a thorough investigation of the cause. During the investigation, identification of hypoglycemia associated with inappropriately high levels of insulin and C-peptide should prompt the exclusion of rare causes of hypoglycemia, including pancreatic islet-cells disease and autoimmune hypoglycemia. In this paper, we describe two cases of hypoglycemia associated with endogenous hyperinsulinism, whose causes are uncommon in clinical practice, and review important aspects of the diagnosis and treatment of hyperinsulinemic hypoglycemia.
authors.affiliation: Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal.
authors.forename: Ana Pires
authors.initials: AP
authors.lastname: Gonçalves
authors.affiliation: Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Baptista
authors.affiliation: Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal.
authors.forename: Ema
authors.initials: E
authors.lastname: Nobre
authors.affiliation: Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal.
authors.forename: Isabel do
authors.initials: Id
authors.lastname: Carmo
mesh_terms: D002096:C-Peptide / Q000097:blood; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology*; D007003:Hypoglycemia / Q000209:etiology*; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications*; D011384:Proinsulin / Q000097:blood; D014463:Ultrasonography
chemical_list: D002096:C-Peptide; D007328:Insulin; D011384:Proinsulin