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Interpreting insulin immunoassays during investigation of apparent spontaneous hypoglycaemia and insulin overdose

Abstract

We report two cases of hypoglycaemia; one with apparently spontaneous hypoglycaemia and one with presumed insulin overdose. In both cases insulin concentration was normal when measured with the Roche immunoassay, but elevated when remeasured with the Advia Centaur immunoassay and a diagnosis of hypoglycaemia secondary to insulin analogue administration was made. These cases highlight that physicians need to understand the binding characteristics of the insulin immunoassay they use.

Type Journal
Authors Chemmanam J, Isaacs I, Jones GR, Greenfield JR, Burt MG
Responsible Garvan Author Professor Jerry Greenfield
Publisher Name INTERNAL MEDICINE JOURNAL
Published Date 2017-12-10
Published Volume 47
Published Issue 12
Published Pages 1448-1451
Status Published in-print
DOI 10.1111/imj.13644
URL link to publisher's version https://www.ncbi.nlm.nih.gov/pubmed/29224198
OpenAccess link to author's accepted manuscript version https://publications.gimr.garvan.org.au/open-access/14361