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Pseudoinsulinoma Syndrome from Inadvertent Tolazamide Ingestion

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The Division of Endocrinology and Internal Medicine, Mayo Clinic and Mayo Foundation; Rochester, Minnesota

Ann Intern Med. 1980;93(2):281-282. doi:10.7326/0003-4819-93-2-281
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We describe a patient with chronic, inadvertent sulfonylurea ingestion that masqueraded both clinically and biochemically as an insulinoma.

A 70-year-old white housewife was referred to the Mayo Clinic for further evaluation of a suspected insulinoma. During the preceding 3 months, she had complained of episodic weakness, confusion, sweating, and palpitations. The spells generally occurred before breakfast and after exertion. Food promptly relieved her symptoms; she learned to eat three to four candy bars each night to abort the spells. Four days before her transfer, the patient was found semicomatose and brought to an emergency room in her local community, where


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