Loeb Thomas, Ozguler Anna, Baer Geraldine, Baer Michel
SAMU des Hauts-de-Seine, Assistance Publique - Hôpitaux de Paris, Raymond Poincaré Hospital, University of Paris-Saclay, 104 boulevard Raymond Poincaré, 92 380, Garches, France.
Department of Emergency Medicine, Corporal Michael J. Crescenz VA Medical Center, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
Int J Emerg Med. 2021 Apr 21;14(1):23. doi: 10.1186/s12245-021-00348-7.
Hypoglycemia usually includes various neurological symptoms, which are the consequence of neuroglycopenia. When it is severe, it is associated with altered mental status, even coma.
We report the case of a patient with severe hypoglycemia, completely asymptomatic, due to the increase of lactate production in response to tissue hypoperfusion following a hemorrhagic shock. This illustrates that lactate can substitute glucose as an energy substrate for the brain. It is also a reminder that this metabolite, despite its bad reputation maintained by its role as a marker of severity in critical care patients, has a fundamental role in our metabolism.
Following the example of the "happy hypoxemia" recently reported in the literature describing asymptomatic hypoxemia in COVID-19 patients, we describe a case of "happy hypoglycemia."
低血糖通常包括各种神经症状，这是神经低血糖症的后果。严重时，它与精神状态改变甚至昏迷有关。
我们报告一例严重低血糖患者，该患者完全无症状，其病因是出血性休克后组织灌注不足导致乳酸生成增加。这表明乳酸可以替代葡萄糖作为大脑的能量底物。这也提醒我们，尽管这种代谢物因其在重症患者中作为严重程度标志物的作用而声名不佳，但它在我们的新陈代谢中具有重要作用。
以最近文献中报道的描述COVID-19患者无症状低氧血症的“快乐低氧血症”为例，我们描述了一例“快乐低血糖症”。
