·病例报告·

      【提要】 患者女，76岁，主因“反复意识模糊1.5个月，再发1 h”入院。患者甲状腺功能亢进4个月，口服甲巯咪唑治疗后反复出现意识模糊，喂食糖水后症状缓解。入院后上述症状发作时血糖偏低(最低2.07 mmol/L)、胰岛素偏高(最高171.20 μU/ml)，停用甲巯咪唑并给予少食多餐后，患者未再出现上述症状，根据临床特征诊断为胰岛素自身免疫综合征(IAS)。

　　【关键词】 甲巯咪唑;胰岛素自身免疫综合征;低血糖症

　　Hyperinsulinemia and hypoglycemia related with Methimazole treatment：One case report ZHANG Xiao-mei，WANG Yu-nan，ZHU Li-mei，et al. Department of Endocrinology，The First Hospital of Dandong，Dandong 118000，China

　　Corresponding author：WANG Yu-nan，E-mail：834800308@qq.com

　　【Summary】 A woman，76 years old，with a history of hyperthyroidism and antithroid treatment for four months，was admitted due to "repeated confusion for half a month and recurrence for an hour". Half a month before admission，the patient presented with recurred episodes of confusion，which could be relieved after feeding sugar. We detected the levels of glucose and insulin while the confusion happened again. The lowest glucose level reached 2.07 mmol/L and the insulin level was high up to 171.20 μU/ml. The above symptoms disappeared when we stopped the treatment of methimazole and gave her more meals a day but less food at each time. According to the clinical manifestations and treatment process，insulin autoimmune syndrome (IAS) was diagnosed.

　　【Key words】 Methimazole;Insulin autoimmune syndrome(IAS);Hypoglycemia