• Der Internist · Sep 2020

    Case Reports

    [Intermittent disturbances of perception during fasting in a 46-year-old female patient].

    • S Ravens and L Scheit.
    • Klinik I Innere Medizin, Bundeswehrkrankenhaus Hamburg, Lesserstraße 180, 22049, Hamburg, Deutschland.
    • Internist (Berl). 2020 Sep 1; 61 (9): 964-968.

    BackgroundWe report the case of a 46-year-old female patient who presented in the emergency department with intermittent disturbances of perception when fasting.DiagnosticsIn the diagnostic fasting test, a hyperinsulinemic hypoglycemia already occurred after 7h. A sonographic examination was inconspicuous, therefore, a Ga 68-HA-DOTATATE positron emission tomography computed tomography (PET-CT) was carried out. The results were indicative of a neuroendocrine neoplasm, which gave rise to the suspicion of an insulinoma.Clinical CourseFor surgical treatment the patient was transferred to an external hospital. Following surgery, the patient was free of symptoms.ConclusionIf multiple symptoms of hypoglycemia are present, an insulinoma as the cause must be considered in the differential diagnostics.

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