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Clinical Chemistry 47: 795-796, 2001;
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(Clinical Chemistry. 2001;47:795-796.)
© 2001 American Association for Clinical Chemistry, Inc.

Letters

Autoimmune Hypoglycemia Presenting as Seizure One Week after Surgery

Michael Vogeser1,a, Klaus G. Parhofer2, Heinrich Fürst3, Karl Jacob1, Ulrich C. Brödl2 and Dietrich Seidel1

1 Institute of Clinical Chemistry,,
2 Department of Internal Medicine II,, and,
3 Department of Surgery, Ludwig-Maximilians-Universität Munich, Klinikum Grosshadern, D-81366 Munich, Germany
a Author for correspondence. Fax 49-89-7095-3240; e-mail mvogeser@klch.med.uni-muenchen.de.


To the Editor:

A 72-year-old Caucasian man was admitted to our hospital in November 1999 for reanastomosis of an ileostoma that had been created after perforation of a sigmoid diverticulum with peritonitis. The past medical history of the patient was unremarkable except for angioneurotic edema of unknown etiology 14 years previously. The immediate postoperative course was uneventful, and the patient received glucose (400 g/L, 40 mL/h) via a central line. Because it was planned to reestablish enteral nutrition on day 7, glucose infusions were discontinued during the preceding night. At 0500 on day 7, the patient had a generalized seizure. Bedside testing revealed a nondetectable blood glucose concentration. After the patient received 100 mL of a glucose solution (500 g/L), the seizures stopped. During the following 24 h, his glucose concentration repeatedly fell to <2.8 mmol/L, requiring glucose administration; 36 h after the initial hypoglycemia, the patient was on full . . . [Full Text of this Article]


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