eMedicine Specialties > Endocrinology > Diabetes Mellitus

Pseudohypoglycemia: Follow-up

Author: Robert A Gabbay, MD, PhD, Associate Professor of Medicine, Division of Endocrinology, Diabetes and Metabolism, Laurence M Demers Career Development Professor, Penn State College of Medicine; Director, Diabetes Program, Penn State Milton S Hershey Medical Center; Executive Director, Penn State Institute for Diabetes and Obesity
Coauthor(s): Irina Lendel, MD, Clinical Instructor in Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Milton S Hershey Medical Center; Klaus Radebold, MD, PhD, Research Associate, Department of Surgery, Yale University School of Medicine; George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
Contributor Information and Disclosures

Updated: Jan 14, 2010

Follow-up

Deterrence/Prevention

  • Refrigerate or add an antiglycolytic agent (sodium fluoride) to the samples.
  • Promptly separate plasma from the formed elements of the blood.

Miscellaneous

Special Concerns

Occasionally, neoplasms may cause episodes of true hypoglycemia by (1) releasing insulinlike compounds, as described for mesotheliomas of the retroperitoneal space, fibromas, and mesenchymal tumors; (2) rapid metabolism of glucose by large numbers of leukemic cells; (3) trapping of insulin by monoclonal IgG immunoglobulins in multiple myeloma; and (4) a deficiency in liver glucose-6-phosphatase or extensive liver involvement.

 


More on Pseudohypoglycemia

Overview: Pseudohypoglycemia
Differential Diagnoses & Workup: Pseudohypoglycemia
Follow-up: Pseudohypoglycemia
References
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References

  1. El Khoury M, Yousuf F, Martin V, et al. Pseudohypoglycemia: a cause for unreliable finger-stick glucose measurements. Endocr Pract. Apr 2008;14(3):337-9. [Medline].

  2. Jokinen CH, Swaim WR, Nuttall FQ. A case of hereditary xerocytosis diagnosed as a result of suspected hypoglycemia and observed low glycohemoglobin. J Lab Clin Med. Jul 2004;144(1):27-30. [Medline].

  3. Assaad SN, Vassilopoulou-Sellin R, Samaan NA. Pseudohypoglycemia in chronic leukemia. Tex Med. Jul 1988;84(7):36-7. [Medline].

  4. Astles JR, Petros WP, Peters WP, Sedor FA. Artifactual hypoglycemia associated with hematopoietic cytokines. Arch Pathol Lab Med. Aug 1995;119(8):713-6. [Medline].

  5. Canivet B, Elbaze P, Dujardin P. Pseudohypoglycemia in a patient with leukemia [letter]. Biomedicine. Dec 1981;35(7-8):203-4. [Medline].

  6. Elks ML. Pseudohypoglycemia in adult victims of adolescent incest. South Med J. Nov 1990;83(11):1338-40. [Medline].

  7. Farfel Z, Freimark D, Mayan H, Gafni J. Spurious hypoglycemia, hyperkalemia and hypoxemia in chronic hemolytic anemia. Isr J Med Sci. Nov 1990;26(11):606-10. [Medline].

  8. Glasheen JJ, Sorensen MD. Burkitt's lymphoma presenting with lactic acidosis and hypoglycemia - a case presentation. Leuk Lymphoma. Feb 2005;46(2):281-3. [Medline].

  9. Gregory JW, Aynsley-Green A. The definition of hypoglycaemia. Baillieres Clin Endocrinol Metab. Jul 1993;7(3):587-90. [Medline].

  10. Haibach H, Wright DL, Bailey LE. Pseudohypoglycemia in a patient with Waldenstrom's macroglobulinemia, an artifact of hyperviscosity [letter]. Clin Chem. Jun 1986;32(6):1239-40. [Medline].

  11. Kagawa D, Ando S, Ueda T. [A case of chronic myelogenous leukemia with pseudohypoglycemia: correlation between leukocyte counts and blood glucose levels]. Rinsho Ketsueki. Oct 1987;28(10):1790-4. [Medline].

  12. MacDuff A, Grant IS. Facticious hypoglycaemia in hypotension. Emerg Med J. Jul 2002;19(4):376. [Medline].

  13. Nagase T, Adachi I, Yamada T, Murakami N, Morita K, Yoshino Y. Solitary fibrous tumor in the pelvic cavity with hypoglycemia: report of a case. Surg Today. 2005;35(2):181-4. [Medline].

  14. Nieman RE, Kelly JJ, Waskin HA. Severe African trypanosomiasis with spurious hypoglycemia. J Infect Dis. Feb 1989;159(2):360-2. [Medline].

  15. Petrella V, Silvera F, Massara G. [Syndrome of clinical pseudohypoglycemia]. Minerva Med. Nov 30 1984;75(45-46):2751-4. [Medline].

  16. Pink D, Schoeler D, Lindner T, Thuss-Patience PC, Kretzschmar A, Knipp H. Severe hypoglycemia caused by paraneoplastic production of IGF-II in patients with advanced gastrointestinal stromal tumors: a report of two cases. J Clin Oncol. Sep 20 2005;23(27):6809-11. [Medline].

  17. Rushakoff RJ, Lewis SB. Case of pseudohypoglycemia. Diabetes Care. Dec 2001;24(12):2157-8. [Medline].

  18. Wakami K, Tateyama H, Kawashima H, Matsuno T, Kamiya Y, Jin-No Y. Solitary fibrous tumor of the uterus producing high-molecular-weight insulin-like growth factor II and associated with hypoglycemia. Int J Gynecol Pathol. Jan 2005;24(1):79-84. [Medline].

  19. Wenk RE, Yoho S, Bengzon A. Pseudohypoglycemia with monoclonal immunoglobulin m. Arch Pathol Lab Med. Apr 2005;129(4):454-5. [Medline].

  20. Ybarra J, Isern J. Leukocytosis-induced artifactual hypoglycemia. Endocr J. Aug 2003;50(4):481-2. [Medline].

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Further Reading

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Keywords

pseudohypoglycemia, hypoglycemia, glycolysis, leukocytosis, macroglobulinemia, glycolytic, Waldenstrom macroglobulinemia

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Contributor Information and Disclosures

Author

Robert A Gabbay, MD, PhD, Associate Professor of Medicine, Division of Endocrinology, Diabetes and Metabolism, Laurence M Demers Career Development Professor, Penn State College of Medicine; Director, Diabetes Program, Penn State Milton S Hershey Medical Center; Executive Director, Penn State Institute for Diabetes and Obesity
Robert A Gabbay, MD, PhD is a member of the following medical societies: American Association of Clinical Endocrinologists, American Diabetes Association, and Endocrine Society
Disclosure: Novo Nordisk Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching

Coauthor(s)

Irina Lendel, MD, Clinical Instructor in Endocrinology, Division of Endocrinology, Diabetes, and Metabolism, Milton S Hershey Medical Center
Disclosure: Nothing to disclose.

Klaus Radebold, MD, PhD, Research Associate, Department of Surgery, Yale University School of Medicine
Klaus Radebold, MD, PhD is a member of the following medical societies: American Gastroenterological Association and New York Academy of Sciences
Disclosure: Nothing to disclose.

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

Medical Editor

Dimitris A Papanicolaou, MD, Assistant Professor, Department of Medicine/Endocrinology, Emory University
Dimitris A Papanicolaou, MD is a member of the following medical societies: American College of Physicians, Endocrine Society, and Royal Society of Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Yoram Shenker, MD, Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison
Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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