Artifactual Hypoglycaemia Associated With Cyanotic Congenital Heart Disease: a New Perspective towards Understanding

Abstract

Hypoglycemia remains an infrequently and potentially dangerous complication in all patients. Patients who are suspected of having hypoglycemia should be questionable until confirmed by appropriate tests. Herein, we report clinical findings of three cyanotic congenital heart disease cases diagnosed artifactual hypoglycaemia, including an updated review of literature of artifactual hypoglycaemia. The cyanotic congenital heart disease led to secondary erythrocytosis, which provided the high levels of erythrocytes that we believe caused the artifactual hypoglycemia in combination with delayed processing of the sample. Currently, there are few specific studies on cyanotic congenital heart disease cases diagnosed artifactual hypoglycaemia. The report of our cases and the literature review underline the unnecessary of a detailed work-up for artifactual hypoglycaemia can be avoided if it is suspected in patients with cyanotic congenital heart disease. Clinicians should consider potential discrepancy in asymptomatic individuals before initiating costly examination. Our paper may represent the tip of the iceberg and raises concerns about the proper management of individuals with artifactual hypoglycaemia in cyanotic congenital heart disease.