Hepatic hypoglycemia has been recognized since 1929, but only one series records chronic passive congestion of the liver as the cause. This case report describes rheumatic heart disease with congestive failure and superimposed profound shock of 24 hours' duration. The resulting hypoglycemia is the lowest blood sugar of hepatic origin recorded in the medical literature. Infarction of the bowel without mesenteric thrombosis was responsible for the irreversible shock.
Report of a Case
A 49-year-old white woman was admitted to the hospital on Feb 15, 1962, because of abdominal pain of 24 hours' duration.
—The patient had had rheumatic heart disease for 20 years. When she was first seen four months before admission, dyspnea, orthopnea, and ankle edema were present. The apical rate was 150 per minute with atrial fibrillation. Digitalis was reinstituted, an unknown quantity having previously been taken intermittently in the past. With a maintenance dose of 0.2
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 8
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.