Explaining unexplained hypoglycemia: How LC-MS/MS can help

M T Ackermans; J Hopman; A C Heijboer; S E Siegelaar

doi:10.1016/j.plabm.2022.e00291

Explaining unexplained hypoglycemia: How LC-MS/MS can help

Pract Lab Med. 2022 Jul 12:31:e00291. doi: 10.1016/j.plabm.2022.e00291. eCollection 2022 Aug.

Authors

M T Ackermans¹, J Hopman², A C Heijboer^{1

3}, S E Siegelaar⁴

Affiliations

¹ Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, the Netherlands.
² Department of Emergency Medicine, Haaglanden Medical Center, The Hague, the Netherlands.
³ Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands.
⁴ Department of Internal Medicine, Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Abstract

Explaining hypoglycaemia, especially in patients without diabetes mellitus, is challenging. Here we present a case, where the added value for clinical diagnosis of insulin determination with liquid chromatography-mass spectrometry (LC-MS/MS) is shown. By the use of LC-MS/MS the different insulin analogues can be identified. The confirmation of an insulin analogue present during hypoglycaemia facilitated in our case the discussion with the patient and his family about what happened.

Publication types

Case Reports