Lagan Valley Hospital, South Eastern Health and Social Care Trust, Lisburn BT28 1JP, UK.
Age Ageing. 2022 Mar 1;51(3). doi: 10.1093/ageing/afac055.
We present the case of an 83-year-old woman with recurrent episodes of delirium occurring overnight, associated with hypoglycaemia. Other causes for delirium were excluded. Laboratory findings were in keeping with endogenous insulin production. Computerised tomography imaging revealed a small mass in the pancreas supporting a presumed diagnosis of an insulinoma. Given the patient's frailty and cognitive impairment, a conservative management approach was taken. Diazoxide was commenced with resolution of episodes of delirium. This case highlights hypoglycaemia, and insulinoma, as a rare, but treatable cause of delirium. It demonstrates the importance of blood sugar screening in delirium. It emphasises the holistic modifications to management, which must be taken to ensure patient-centred care when caring for an older adult living with frailty, who may have cognitive impairment.
我们报告了一例 83 岁老年女性患者，其反复发作的谵妄症状仅在夜间出现，同时伴有低血糖。已排除其他导致谵妄的原因。实验室检查结果符合内源性胰岛素分泌。计算机断层扫描成像显示胰腺内有一小肿块，支持胰岛素瘤的诊断。鉴于患者身体虚弱和认知障碍，我们采取了保守治疗方法。开始使用二氮嗪治疗后，谵妄发作得到缓解。本病例强调了低血糖和胰岛素瘤是导致谵妄的罕见但可治疗的原因。它还说明了在谵妄患者中进行血糖筛查的重要性。它强调了在照顾患有衰弱和认知障碍的老年患者时，必须进行全面的管理调整，以确保以患者为中心的护理。
