Keeping a Low Profile: Insulinoma

A young patient experienced a major lapse of memory, which led to hospitalization and the diagnosis of a rare but curable disease. An otherwise healthy 21-year-old man was brought to the emergency department by his partner after he forgot to pick her up from the airport despite several reminders. His partner and father described that he had become forgetful over the past 6 months, unreliable in his responsibilities, and increasingly impatient with a quick temper. He experienced bouts of confusion lasting minutes during which he was unable to answer questions and noticed diffuse body sweating and shaking of his arms. He began to forget recent conversations and events. He did not seek medical attention despite being advised to do so by family. He denied fevers, chills, focal pain, headaches, neck stiffness, weight changes, weakness, speech or vision changes, or mood symptoms.