EJMCR. 2020; 4(4): 134-137

A 36-year-old man presenting with altered mental status and hypoglycaemia

Authors: Gabriel Atanasio, Maria Ana Canelas, Joana Mascarenhas.

ABSTRACT

Background: Hypoglycaemia is more frequent among diabetic patients as a result of hypoglycaemic lowering therapies, making the diagnosis and management straightforward. However, when documented in nondiabetic people, it becomes a diagnostic problem. Despite their seemingly benign behaviour, the aetiology and posterior treatment is of crucial importance, since recurrences are frequent and prolonged hypoglycaemia can cause serious brain lesions, making mortality higher among nondiabetic patients. Case Presentation: A 36-year-old man was admitted to our hospital due to an episode of altered mental status with documented hypoglycaemia. The patient had no medical conditions known and was only on zonidamide. He denied drinking alcoholic beverages and had no other symptoms. Physical examination, on the emergency department, as well as blood test was normal, and he was admitted to study the cause of hypoglycaemia. After the 72-hour fast test, endogenous hyperinsulinism was diagnosed and the team initiated the investigation of a possible insulinoma, which was later found to be in pancreatic location. The patient was referred for surgical resection of the insulinoma and was discharged home 7 days after the surgery. He recovered well without further symptoms of hypoglycaemia. Conclusion: The authors want to highlight the rarity of hypoglycaemia among non-diabetic patients emphasising endogenous hyperinsulinism as an unusual cause of it, infrequently as a result of an insulinoma. Despite its rarity, once the correct treatment is chosen the prognosis is good and the overall survival rate does not differ from that expected in the general.

Keywords:
Spontaneous hypoglycaemia, endogenous hyperinsulinism, Insulinoma


View PDF
A 36-year-old man presenting with altered mental status and hypoglycaemia


Authors
Gabriel Atanasio
Centro Hospitalar Vila Nova de Gaia / Espinho, Vila Nova de Gaia, Portugal
PubMed articlesGoogle scholar articles

Maria Ana Canelas
Centro Hospitalar Vila Nova de Gaia / Espinho, Vila Nova de Gaia, Portugal
PubMed articlesGoogle scholar articles

Joana Mascarenhas
Centro Hospitalar Vila Nova de Gaia / Espinho, Vila Nova de Gaia, Portugal
PubMed articlesGoogle scholar articles


Correspondence to:
. Gabriel Atanásio, Physician at the Internal Medicine Department of Centro Hospitalar Vila Nova de Gaia/Espinho. R. Conceicao Fernandes, Vila Nova de Gaia, Portugal.; gabrielatanasio@hotmail.com

Publication history
Received 18 Dec 2019
Revised 09 Mar 2020
Accepted 14 Apr 2020
Published online 26 Apr 2020
Published in print 24 May 2020

How to cite this article?

Export to EndNote Export to refMan

Pubmed Style

Atanasio G, Canelas MA, Mascarenhas J. A 36-year-old man presenting with altered mental status and hypoglycaemia. EJMCR. 2020; 4(4): 134-137. doi:10.24911/ejmcr/173-1576675738


Web Style

Atanasio G, Canelas MA, Mascarenhas J. A 36-year-old man presenting with altered mental status and hypoglycaemia. https://www.ejmcr.com/?mno=78502 [Access: July 11, 2020]. doi:10.24911/ejmcr/173-1576675738


AMA (American Medical Association) Style

Atanasio G, Canelas MA, Mascarenhas J. A 36-year-old man presenting with altered mental status and hypoglycaemia. EJMCR. 2020; 4(4): 134-137. doi:10.24911/ejmcr/173-1576675738


Vancouver/ICMJE Style

Atanasio G, Canelas MA, Mascarenhas J. A 36-year-old man presenting with altered mental status and hypoglycaemia. EJMCR. (2020), [cited July 11, 2020]; 4(4): 134-137. doi:10.24911/ejmcr/173-1576675738


Harvard Style

Atanasio, G., Canelas, . M. A. & Mascarenhas, . J. (2020) A 36-year-old man presenting with altered mental status and hypoglycaemia. EJMCR, 4 (4), 134-137. doi:10.24911/ejmcr/173-1576675738


Turabian Style

Atanasio, Gabriel, Maria Ana Canelas, and Joana Mascarenhas. 2020. A 36-year-old man presenting with altered mental status and hypoglycaemia. European Journal of Medical Case Reports, 4 (4), 134-137. doi:10.24911/ejmcr/173-1576675738


Chicago Style

Atanasio, Gabriel, Maria Ana Canelas, and Joana Mascarenhas. "A 36-year-old man presenting with altered mental status and hypoglycaemia." European Journal of Medical Case Reports 4 (2020), 134-137. doi:10.24911/ejmcr/173-1576675738


MLA (The Modern Language Association) Style

Atanasio, Gabriel, Maria Ana Canelas, and Joana Mascarenhas. "A 36-year-old man presenting with altered mental status and hypoglycaemia." European Journal of Medical Case Reports 4.4 (2020), 134-137. Print. doi:10.24911/ejmcr/173-1576675738


APA (American Psychological Association) Style

Atanasio, G., Canelas, . M. A. & Mascarenhas, . J. (2020) A 36-year-old man presenting with altered mental status and hypoglycaemia. European Journal of Medical Case Reports, 4 (4), 134-137. doi:10.24911/ejmcr/173-1576675738


Share this article

Click the icon of the social media platform on which you would like to share this article.

Article Statistics

Request permissions

If you wish to reuse any part or all of this article please contact the copyright holder, contact@ejmcr.com.

Copyright © 2018 Discover Publishing Group. All Rights Reserved.