Der Internist
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Case Reports
[Insulin autoimmune syndrome : A rare, but important differential diagnosis of hypoglycemia].
A 69-year-old female patient was referred to the Medical University of Hanover for further diagnostic evaluation of recurrent severe hypoglycemia. The patient had previously been started on clopidogrel after arterial stenting for peripheral arterial obstructive disease (PAOD). ⋯ An insulin autoimmune syndrome was diagnosed, most likely induced by the prior intake of clopidogrel. Treatment with immunoadsorption was initiated, achieving a significant reduction in hypoglycemic events and a lasting response to treatment over 3 months.
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This article presents the case of a 28-year-old male patient with a renal infarction due to an embolizing traumatic postdissection aneurysm of a renal segmental artery. He presented with abdominal and flank pain 1.5 years after a motorcycle accident. ⋯ Other causes of renal infarction were excluded. After an interdisciplinary discussion we decided to use interventional coiling in this young and athletically active patient in order to avoid long-term anticoagulation.