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Insulinoma Masquerading as Transient Neurocognitive Impairment
A 55-year-old man presented with 6 months of increasingly frequent episodes of confusion and abnormal behavior (Video 1). Neurologic examination and diagnostic work-up were unremarkable. He was evaluated for stroke, Huntington's disease, conversion disorder, and other neuropsychiatric conditions without a satisfactory diagnosis. Months later, he suffered another episode and was found to have a glucose of 33mg/dL. This improved with glucose administration but rapidly dropped to 30mg/dL. A 72-hour fast, which revealed a low serum glucose and elevated insulin, pro-insulin, and C-peptide levels, strongly suggested the diagnosis of insulinoma.
Source: The American Journal of Medicine - May 10, 2018 Category: General Medicine Authors: Daniel Varela, Amy Yu, David Saxon Tags: Clinical Communication to the Editor Source Type: research

Insulinoma Masquerading as Transient Neurocognitive Impairment ✰, ✰✰, ✰✰✰
A 55-year-old man presented with six months of increasingly frequent episodes of confusion and abnormal behavior (Video 1). Neurologic examination and diagnostic workup were unremarkable. He was evaluated for stroke, Huntington's disease, conversion disorder, and other neuropsychiatric conditions without a satisfactory diagnosis. Months later, he suffered another episode and was found to have a glucose of 33 mg/dL. This improved with glucose administration, but rapidly dropped to 30 mg/dL. A 72-hour fast, which revealed a low serum glucose and elevated insulin, pro-insulin, and c-peptide levels, strongly suggested the diagnosis of insulinoma.
Source: The American Journal of Medicine - May 10, 2018 Category: General Medicine Authors: Daniel Varela, Amy Yu, David Saxon Tags: Clinical Communication to the Editor Source Type: research