Artifactual hypoglycemia in a patient with systemic sclerosis
Jonathan Mertens1, Maryam Haddad2
1Department of Internal Medicine, University Hospital Antwerp, Antwerp, Belgium.
Acta Clinica Belgica
|October 19, 2020
Summary
Systemic sclerosis can cause artifactual hypoglycemia, leading to falsely low blood glucose readings. Recognizing this link prevents misdiagnosis and unnecessary treatments, with continuous glucose monitoring as a future solution.
Area of Science:
- Endocrinology
- Rheumatology
- Clinical Chemistry
Background:
- Artifactual hypoglycemia arises from discrepancies between lab and actual blood glucose.
- Conditions affecting capillary microcirculation can cause falsely low glucose assessments.
- Systemic sclerosis involves autoimmunity, fibrosis, and small vessel vasculopathy.
Observation:
- An 87-year-old woman presented with recurrent, asymptomatic hypoglycemia.
- Clinical examination revealed features of limited cutaneous systemic sclerosis.
- Microvascular damage from systemic sclerosis was identified as the cause.
Findings:
- Systemic sclerosis can interfere with point-of-care (POC) glycemia measurements.
- This interference leads to artifactual hypoglycemia and potential misdiagnosis.
- The patient's condition was attributed to microvascular damage from systemic sclerosis.
Implications:
- Artifactual hypoglycemia is underrecognized by physicians.
- Early identification of inaccurate glycemia assessment is crucial.
- Continuous glucose monitoring (CGM) may offer a reliable alternative for inpatient monitoring.
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