An unusual cause of hypoglycemia; the case of a male patient with Munchausen’s Syndrome
Munchausen’s Syndrome is a psychiatric illness in which patients create potentially life-threatening symptoms for the purpose of admission to a hospital or other primary gains. A 23-year-old male patient was admitted to the Inonu University, Turgut Ozal Medical Center Endocrinology Inpatient Unit with hypoglycemic attacks. The patient had hypoglycemia that required intensive dextrose infusion. Studies conducted after his hospitalization revealed that the patient intentionally injected himself with high doses of insulin in order to be hospitalized. A diagnosis of factitious hypoglycemia and Munchausen Syndrome (MS) was made. The patient was followed up with recommendations from the psychiatry department. Factitious hypoglycemia, resulting from deliberate usage of blood glucose-lowering medications in the absence of hyperglycemia, is characterized by frequent episodes of hypoglycemia and recurrent hospitalizations and causes a variety of severe symptoms. Typical signs include low blood glucose levels, suppressed c-peptide and pro-insulin levels, and inappropriately high insulin levels. The purpose behind the current case report is to emphasize the significance of considering MS in the differential diagnosis of patients presenting with hypoglycemia and, although it is more prevalent among females, to demonstrate that this psychiatric illness can also present itself among male patients.
Keywords: Hypoglycemia, insulin, Munchausen Syndrome