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Factitious hypoglycemia. Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies.
N Engl J Med. 1977 Nov 10; 297(19):1029-32.NEJM

Abstract

In seven patients with factitious hypoglycemia due to the surreptitious injection of insulin, we made the diagnosis by measurements of plasma insulin and C-peptide immunoreactivity (in seven patients), facilitated by the finding of circulating insulin-binding antibodies (in two patients). The simultaneous demonstration of low plasma glucose, high immunoreactive insulin and suppressed C-peptide immunoreactivity represents a triad of results pathognomonic of exogenous insulin administration. Determination of plasma free C-peptide and free insulin permitted patients with high titers of insulin antibodies, including those with a history of insulin-treated diabetes, to be studied and diagnosed in a way similar to that in subjects who had no circulating insulin antibodies.

Authors

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Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

198659

Citation

Scarlett, J A., et al. "Factitious Hypoglycemia. Diagnosis By Measurement of Serum C-peptide Immunoreactivity and Insulin-binding Antibodies." The New England Journal of Medicine, vol. 297, no. 19, 1977, pp. 1029-32.
Scarlett JA, Mako ME, Rubenstein AH, et al. Factitious hypoglycemia. Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies. N Engl J Med. 1977;297(19):1029-32.
Scarlett, J. A., Mako, M. E., Rubenstein, A. H., Blix, P. M., Goldman, J., Horwitz, D. L., Tager, H., Jaspan, J. B., Stjernholm, M. R., & Olefsky, J. M. (1977). Factitious hypoglycemia. Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies. The New England Journal of Medicine, 297(19), 1029-32.
Scarlett JA, et al. Factitious Hypoglycemia. Diagnosis By Measurement of Serum C-peptide Immunoreactivity and Insulin-binding Antibodies. N Engl J Med. 1977 Nov 10;297(19):1029-32. PubMed PMID: 198659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factitious hypoglycemia. Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies. AU - Scarlett,J A, AU - Mako,M E, AU - Rubenstein,A H, AU - Blix,P M, AU - Goldman,J, AU - Horwitz,D L, AU - Tager,H, AU - Jaspan,J B, AU - Stjernholm,M R, AU - Olefsky,J M, PY - 1977/11/10/pubmed PY - 1977/11/10/medline PY - 1977/11/10/entrez SP - 1029 EP - 32 JF - The New England journal of medicine JO - N Engl J Med VL - 297 IS - 19 N2 - In seven patients with factitious hypoglycemia due to the surreptitious injection of insulin, we made the diagnosis by measurements of plasma insulin and C-peptide immunoreactivity (in seven patients), facilitated by the finding of circulating insulin-binding antibodies (in two patients). The simultaneous demonstration of low plasma glucose, high immunoreactive insulin and suppressed C-peptide immunoreactivity represents a triad of results pathognomonic of exogenous insulin administration. Determination of plasma free C-peptide and free insulin permitted patients with high titers of insulin antibodies, including those with a history of insulin-treated diabetes, to be studied and diagnosed in a way similar to that in subjects who had no circulating insulin antibodies. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/198659/Factitious_hypoglycemia__Diagnosis_by_measurement_of_serum_C_peptide_immunoreactivity_and_insulin_binding_antibodies_ L2 - https://www.nejm.org/doi/10.1056/NEJM197711102971903?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -