Padarabinda Tripathy Krishna, Pathi Debasis, Kumar Behera Pradip, Das Sambit, Tarun Venkat Mahesh Sangam
General Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Endocrinology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2024 Mar 16;16(3):e56297. doi: 10.7759/cureus.56297. eCollection 2024 Mar.
Hypoglycemia is common in diabetic populations using insulin or insulin secretagogues, but rare in non-diabetics. A 60-year-old non-diabetic male presented with repeated episodes of abnormal behavior persisting for 10-15 minutes for seven days, associated with sweating, intense hunger, and relief on food intake, with no history of insulin or secretagogue intake, with stable vitals and normal systemic examination. Laboratory tests during attacks revealed low blood sugar, high serum insulin, and normal C-peptide levels, with no evidence of pancreatic or extrapancreatic hyperinsulinism, and serum anti-insulin antibody levels >100 U/ml. Based on these results, he was diagnosed with autoimmune insulin syndrome (AIS). Treatment with low-carb meals, oral prednisolone, and acarbose led to the resolution of symptoms. Hirata syndrome, though rare in India, requires consideration as a differential diagnosis to avoid unnecessary invasive procedures.
低血糖在使用胰岛素或胰岛素促泌剂的糖尿病患者中很常见，但在非糖尿病患者中很少见。一名60岁的非糖尿病男性出现反复异常行为发作，持续10 - 15分钟，共7天，伴有出汗、强烈饥饿感，进食后缓解，无胰岛素或促泌剂摄入史，生命体征稳定，全身检查正常。发作期间的实验室检查显示血糖低、血清胰岛素高、C肽水平正常，无胰腺或胰腺外高胰岛素血症证据，血清抗胰岛素抗体水平>100 U/ml。基于这些结果，他被诊断为自身免疫性胰岛素综合征（AIS）。低碳水化合物饮食、口服泼尼松龙和阿卡波糖治疗使症状得到缓解。平田综合征在印度虽罕见，但需作为鉴别诊断加以考虑，以避免不必要的侵入性检查。
