Hypoglycemia is a common presentation for various conditions presenting to the emergency department. After ruling out drugs as a cause, especially in nondiabetic individuals, classification to hyperinsulinemic or non-hyper insulinemic hypoglycemia is the next step. Since insulinoma is one of the most common causes of hyperinsulinemia, several imaging modalities are typically used in the search for it. However, in the presence of autoimmune autoantibody syndrome should be thought of. Here we report a case of an elderly non diabetic female with recurrent hypoglycemia. She was noticed to have late postprandial hypoglycemia. Investigation revealed raised insulin levels, raised C peptide levels, and high titers of insulin auto-antibodies. The patient was diagnosed with Insulin antibody syndrome (IAS). IAS may not be a rare syndrome; physicians need to be more vigilant to diagnose and manage such patients.
Dixit et al. (Thu,) studied this question.