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病例报告:人为性低血糖:一种不应被遗忘的情况。

Case Report: Artifactual Hypoglycemia: A Condition That Should Not Be Forgotten.

机构信息

Department of Endocrinology, Diabetes and Metabolism; Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.

Nova Medical School/Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.

出版信息

Front Endocrinol (Lausanne). 2022 Jul 28;13:951377. doi: 10.3389/fendo.2022.951377. eCollection 2022.

Abstract

BACKGROUND

Hypoglycemia is uncommon in people who are not being treated for diabetes mellitus and, when present, the differential diagnosis is broad. Artifactual hypoglycemia describes discrepancy between low capillary and normal plasma glucose levels regardless of symptoms and should be considered in patients with Raynaud's phenomenon.

CASE PRESENTATION

A 46-year-old female patient with a history of a sleeve gastrectomy started complaining about episodes of lipothymias preceded by sweating, nausea, and dizziness. During one of these episodes, a capillary blood glucose was obtained with a value of 24 mg/dl. She had multiple emergency admissions with low-capillary glycemia. An exhaustive investigation for possible causes of hypoglycemia was made for 18 months. The 72h fasting test was negative for hypoglycemia. A Raynaud's phenomenon was identified during one appointment.

CONCLUSION

Artifactual hypoglycemia has been described in various conditions including Raynaud's phenomenon, peripheral arterial disease, Eisenmenger syndrome, acrocyanosis, or hypothermia. With this case report, we want to reinforce the importance of being aware of this diagnosis to prevent anxiety, unnecessary treatment, and diagnostic tests.

摘要

背景

未接受糖尿病治疗的人群中低血糖并不常见,而当低血糖发生时,鉴别诊断范围很广。假性低血糖描述了毛细血管血糖与正常血浆葡萄糖水平之间的差异,无论是否存在症状,都应考虑到雷诺现象患者中。

病例介绍

一位 46 岁女性患者,既往行袖状胃切除术,开始抱怨出现低血糖发作,伴有出汗、恶心和头晕。在其中一次发作期间,检测毛细血管血糖值为 24mg/dl。她出现多次低血糖危象,进行了 18 个月的全面检查以排除低血糖的可能原因。72 小时禁食试验未发现低血糖。在一次就诊中发现了雷诺现象。

结论

假性低血糖已在多种情况下描述,包括雷诺现象、周围动脉疾病、艾森曼格综合征、肢端发绀或低温症。通过本病例报告,我们强调了认识到这一诊断的重要性,以避免焦虑、不必要的治疗和诊断性检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae84/9371975/8f5eb94436c3/fendo-13-951377-g001.jpg

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