title: Insulinoma in a young female patient with systemic lupus erythematosus: a case report.
abstract: OBJECTIVE
  Fasting hypoglycemia may occur in subjects with systemic lupus erythematosus (SLE) when accompanied with insulin-binding antibodies or insulin-receptor antibodies. However, insulinoma has not been reported in SLE subjects with hypoglycemia.
  
  
  METHODS
  We present a case report and review the relevant literature.
  
  
  RESULTS
  A 26-year-old female with underlying SLE experienced several episodes of neuropsychiatric symptoms in a fasting state. The steroid dosage was titrated up, but in vain. Timely imaging studies showed a pancreatic tumor, and insulinoma was proven by pathology. Hypoglycemia did not recur after surgery.
  
  
  CONCLUSIONS
  Physicians should distinguish insulinoma from autoimmunity-mediated hypoglycemia in SLE patients with fasting hypoglycemia.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Chen
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Jun-Sing
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Jen-I
authors.initials: JI
authors.lastname: Hwang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
authors.affiliation: Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ya-Ju
authors.initials: YJ
authors.lastname: Wu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Cheng-Ming
authors.initials: CM
authors.lastname: Peng
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: I-Te
authors.initials: IT
authors.lastname: Lee