Factitious hypoglycemia : “a never-ending story”?

• DOI: 10.1684/abc.2018.1362
• Publication Date: 2019-08-02T13:24:29Z
• Authors: Jean-Louis Bayart; Mélanie Closset; Alexandra Coulon; Raluca-Maria Furnica; Damien Gruson
• Keywords: Etiology; Nonalcoholic steatohepatitis

Our team of diabetologist is challenged by the case a 41 year-old woman with recurrent hypoglycaemic episodes. Her clinical background was complex with, among others, neuroendocrine tumor, nonalcoholic steatohepatitis and an adrenal insufficiency; these conditions require exploration several potential causes. After excluding endogenous etiology, factitious hypoglycemia quicky suspected clinicians. However, venous samples showed normal insulinemia moderately decreased C-peptide. multidisciplinary discussion facing strong suspicion, were sent to another laboratory confirm insulin results. Substantially supratherapeutics concentrations highlighted. This confirms previous suspicion surreptitious administration recombinant form unrecognized our routinely used analyzer. observation leads us briefly discuss lack cross-reactivities observed many different assays.