Open AccessHypoglycaemia and fits in a thyrotoxic man
Author(s) -
Chamila Mettananda,
H Janaka de Silva,
Roshane Fernando
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.07.2008.0448
Subject(s) - carbimazole , medicine , prednisolone , propylthiouracil , graves' disease , insulin , antithyroid agent , pediatrics , disease , endocrinology , hormone
We report prolonged severe hypoglycaemia with raised serum insulin levels in a Sri Lankan man with recently diagnosed Graves disease being treated with carbimazole. We diagnosed insulin autoimmune syndrome on the basis of raised anti-insulin antibody levels, and this diagnosis was supported by the subsequent course of the illness. The patient recovered completely after carbimazole was replaced with propylthiouracil and he was treated with dextrose infusions, frequent high-carbohydrate meals and a course of prednisolone.