Citation

Dejoie T, Ramos E, Baron S, Bach-Ngohou K, Masson D. Ann. Biol. Clin. (JLE) 2008; 66(1): 82-86.

Vernacular Title

Apport du laboratoire dans le diagnostic d'une hypoglycemie liee a des injections

Affiliation

Service de biochimie, Unité d'hormonologie et de RIA, CHU Hôtel Dieu, Nantes.

Copyright

(Copyright © 2008, John Libbey Eurotext)

DOI

10.1684/abc.2007.0182

PMID

18227008

Abstract

We report the case of a 2 year-old child presented to the emergency department following a seizure. The child was hypotonic and examination was unremarkable but laboratory tests confirmed a severe hypoglycaemia. The insulin level, inappropriately high for the glycemia and the peptide C undetectable suggested exogenous hyperinsulinism. We conclude that the hypoglycaemia was likely the result of Munchhausen syndrome by proxy. The specificity of two immunoassays used (Elecsys Roche and IRMA CisBio) for the synthetic analogues of insulin explains the discrepancy between the insulin levels obtained but was crucially useful to the approach of the cause of the hypoglycaemia.

Language: fr