Endocrine Abstracts

A 22-year-old female Ashkenazy Jewish previously healthy complaint on weakness In glucometer, her sugar level was 50 mg% and she felt better after ingestion of a small amount of sugar. 3 weeks ago while traveling in Peru, she developed thyrotoxicosis and was started mercaptizol 30 mg a day and deralin. She didn’t drink iodine (iodinated preparations for water purification) while traveling and had no pain or fever. In physical examination there where no goiter or exophthalmos While I saw her she was already euthyroid and felt quite good except for tiredness. In literature, we found few case reports of mercaptizol and PTU-induced insulin autoantibodies which cause symptomatic hypoglycaemia. Most cases were described in the Asian population (especially Japanese people) and resolved a few weeks after stopping the drug. In our patient, the hypoglycemia resolved after only one episode and discontinuation of mertcaptizole. We don’t have antibodies titer yet. insulin levels (C -peptide) were relatively high My conclusion is that physicians should be aware of Mercaptizol and PTU induced hypoglycemia which can be life-threatening