title: Spontaneous hypoglycaemia in a patient with Graves' disease.
abstract: A 23-year-old man, on treatment for Graves' disease, presented to the emergency department, with 2 separate episodes of loss of consciousness. During the first episode, the initial serum glucose was 19 mg/mL, and 44 mg/dL during the second episode. The patient was non-diabetic, and had elevated blood insulin, C peptide and insulin antibody levels. His abdominal radiographic findings were normal. He was diagnosed with Hirata disease, and put on propylthiouracil as a replacement for carbimazole. Hypoglycaemia was managed with dextrose infusions and frequent meals. The patient's condition improved and he had no further episodes of hypoglycaemia during the follow-up period.
authors.affiliation: Department of Internal Medicine, Patan Academy of Health Sciences, Kathmandu, Nepal.
authors.forename: Buddhi
authors.initials: B
authors.lastname: Paudyal
authors.affiliation: Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.
authors.forename: Mila
authors.initials: M
authors.lastname: Shakya
authors.affiliation: Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.
authors.forename: Buddha
authors.initials: B
authors.lastname: Basnyat
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002231:Carbimazole / Q000627:therapeutic use; D019468:Disease Management; D005947:Glucose / Q000008:administration & dosage; D006111:Graves Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D011441:Propylthiouracil / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D011441:Propylthiouracil; D002231:Carbimazole; D005947:Glucose