Endocrine Abstracts

Hypoglycemia in non-diabetic patients is a rare event, and autoimmune hypoglycemia with the presence of positive anti-insulin antibodies is even rarer.

We report the case of a 15 years old non diabetic female patient, she was referred to our hospital for recurrent hypoglycemia for 2 weeks before admission to hospital, these are severe hypoglycemia with impaired consciousness. The first step was to eliminate the general causes and factitious hypoglycemia. Adrenal insufficiency was also ruled out. A 72-hour fasting test was performed and the peptide C assay (<0.15 ng/ml), and Insulinemia (<1 mUi/l) were not in favor of endogenous insulin secretion. Autoimmune origin was suspected. The dosage of anti-insulin antibodies was realized with a positive result of 0.7 (Normal: 0.4).

The patient was put on corticosteroid therapy with a regression of hypoglycemic episodes, pending the results of the anti-insulin antibodies after 2 months of corticosteroid therapy. The case of our patient illustrates the importance of an exhaustive exploration in the face of hypoglycemia and of thinking about the autoimmune cause, which remains rare, especially in non-diabetic patients. Keywords Hypoglycemia-non-diabetic-autoimmune-insulin.