{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:33:23Z","timestamp":1774528403270,"version":"3.50.1"},"reference-count":27,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009580","name":"PLA General Hospital","doi-asserted-by":"publisher","award":["22QNFC052"],"award-info":[{"award-number":["22QNFC052"]}],"id":[{"id":"10.13039\/501100009580","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by interlobular bile duct inflammation, which causes fibrosis and cirrhosis. Few studies have explored the association of hypoglycemia with PBC. In this case, a 76-year-old Chinese man diagnosed with PBC developed recurrent comatose episodes. The patient had severe hypoglycemia and slight abnormalities in liver function tests. In addition, the patient had positive results in antimitochondrial antibody, anti-mitochondrial antibody-subtype 2, centromeric protein B antibody, and antisoluble acidic nuclear protein 100 antibody levels, which led to the diagnosis of PBC. The patient also experienced fasting hypoglycemic coma, requiring thorough evaluation to identify potential causes. This case suggests that liver-derived hypoglycemia associated with PBC may be more common than autoimmune-related hypoglycemia in this context.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf030","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T06:47:11Z","timestamp":1744267631000},"source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Hypoglycemic Coma Episodes Associated With Primary Biliary Cirrhosis"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-8969","authenticated-orcid":false,"given":"Yang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Endocrinology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianbin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0961-0329","authenticated-orcid":false,"given":"Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5996-7708","authenticated-orcid":false,"given":"Jing","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, the Eighth Medical Center of PLA General Hospital , Beijing 100091 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"issue":"1","key":"2025041110180145400_luaf030-B1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jhep.2017.03.022","article-title":"EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis","volume":"67","author":"European Association for the Study of the Liver","year":"2017","journal-title":"J Hepatol"},{"issue":"1","key":"2025041110180145400_luaf030-B2","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/1471-230X-10-100","article-title":"Prevalence of primary biliary cirrhosis in adults referring hospital for annual health check-up in southern China","volume":"10","author":"Liu","year":"2010","journal-title":"BMC Gastroenterol"},{"issue":"1","key":"2025041110180145400_luaf030-B3","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/s41395-018-0390-3","article-title":"Diagnosis and management of primary biliary cholangitis","volume":"114","author":"Younossi","year":"2019","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"2025041110180145400_luaf030-B4","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s00125-020-05366-3","article-title":"The consequences of hypoglycaemia","volume":"64","author":"Amiel","year":"2021","journal-title":"Diabetologia"},{"issue":"5","key":"2025041110180145400_luaf030-B5","doi-asserted-by":"crossref","first-page":"686","DOI":"10.7326\/0003-4819-107-5-686","article-title":"Autoimmune thrombocytopenia and primary biliary cirrhosis with hypoglycemia and insulin receptor autoantibodies. A case report","volume":"107","author":"Selinger","year":"1987","journal-title":"Ann Intern Med"},{"issue":"3","key":"2025041110180145400_luaf030-B6","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.revmed.2009.11.004","article-title":"[Recurrent hypoglycemia in a 68-year-old man]","volume":"31","author":"Bossu Estour","year":"2010","journal-title":"Rev Med Interne"},{"issue":"4","key":"2025041110180145400_luaf030-B7","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1055\/s-2002-35710","article-title":"A 38-year-old African-American woman with an unusually rapid progression of \u201cprimary biliary cirrhosis\u201d: a missed opportunity!","volume":"22","author":"van Leeuwen","year":"2002","journal-title":"Semin Liver Dis"},{"issue":"3","key":"2025041110180145400_luaf030-B8","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1210\/jc.2008-1410","article-title":"Evaluation and management of adult hypoglycemic disorders: an endocrine society clinical practice guideline","volume":"94","author":"Cryer","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2025041110180145400_luaf030-B9","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/S0025-6196(12)62083-7","article-title":"Functioning insulinoma\u2013incidence, recurrence, and long-term survival of patients: a 60-year study","volume":"66","author":"Service","year":"1991","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2025041110180145400_luaf030-B10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/s11606-013-2588-9","article-title":"Recurrent hypoglycemia from insulin autoimmune syndrome","volume":"29","author":"Wong","year":"2014","journal-title":"J Gen Intern Med"},{"issue":"6","key":"2025041110180145400_luaf030-B11","doi-asserted-by":"crossref","first-page":"107925","DOI":"10.1016\/j.jdiacomp.2021.107925","article-title":"Hyperglycemia aversiveness\u201d: investigating an overlooked problem among adults with type 1 diabetes","volume":"35","author":"Polonsky","year":"2021","journal-title":"J Diabetes Complications"},{"issue":"4","key":"2025041110180145400_luaf030-B12","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.ecl.2006.09.005","article-title":"Hypoglycemia","volume":"35","author":"Guettier","year":"2006","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"1","key":"2025041110180145400_luaf030-B13","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s12020-016-0902-0","article-title":"Spontaneous hypoglycemia: diagnostic evaluation and management","volume":"53","author":"Kandaswamy","year":"2016","journal-title":"Endocrine"},{"issue":"6","key":"2025041110180145400_luaf030-B14","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1002\/edm2.375","article-title":"Prevalence and characteristics of factitious hypoglycaemia in non-diabetic patients in a department of endocrinology","volume":"5","author":"Oueslati","year":"2022","journal-title":"Endocrinol Diabetes Metab"},{"issue":"5","key":"2025041110180145400_luaf030-B15","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11910-021-01105-2","article-title":"Neurological complications of endocrine emergencies","volume":"21","author":"Cruz-Flores","year":"2021","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"12","key":"2025041110180145400_luaf030-B16","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1038\/nrendo.2014.170","article-title":"Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications","volume":"10","author":"Frier","year":"2014","journal-title":"Nat Rev Endocrinol"},{"key":"2025041110180145400_luaf030-B17","doi-asserted-by":"crossref","first-page":"609","DOI":"10.3389\/fendo.2020.00609","article-title":"Severe hypoglycemia: is it still a threat for children and adolescents with type 1 diabetes?","volume":"11","author":"Urakami","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"4","key":"2025041110180145400_luaf030-B18","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/00325481.2019.1578590","article-title":"Management of hypoglycemia in older adults with type 2 diabetes","volume":"131","author":"Freeman","year":"2019","journal-title":"Postgrad Med"},{"issue":"5","key":"2025041110180145400_luaf030-B19","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1002\/dmrr.865","article-title":"Vascular disease and diabetes: is hypoglycaemia an aggravating factor?","volume":"24","author":"Wright","year":"2008","journal-title":"Diabetes Metab Res Rev"},{"issue":"1","key":"2025041110180145400_luaf030-B20","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s13300-020-00965-0","article-title":"A comparison of validated methods used to assess impaired awareness of hypoglycaemia in type 1 diabetes: an observational study","volume":"12","author":"Ghandi","year":"2021","journal-title":"Diabetes Ther"},{"issue":"1","key":"2025041110180145400_luaf030-B21","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1038\/s41467-022-29488-x","article-title":"A parallel randomised controlled trial of the hypoglycaemia awareness restoration programme for adults with type 1 diabetes and problematic hypoglycaemia despite optimised self-care (HARPdoc)","volume":"13","author":"Amiel","year":"2022","journal-title":"Nat Commun"},{"issue":"1","key":"2025041110180145400_luaf030-B22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/nrm.2017.89","article-title":"Biochemical and cellular properties of insulin receptor signalling","volume":"19","author":"Haeusler","year":"2018","journal-title":"Nat Rev Mol Cell Biol"},{"issue":"1","key":"2025041110180145400_luaf030-B23","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2174\/157339913804143225","article-title":"Regulation of insulin synthesis and secretion and pancreatic Beta-cell dysfunction in diabetes","volume":"9","author":"Fu","year":"2013","journal-title":"Curr Diabetes Rev"},{"issue":"5","key":"2025041110180145400_luaf030-B24","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/s10620-020-06379-z","article-title":"Using the secretion ratios of insulin and C-peptide during the 2-h oral glucose tolerance test to diagnose insulinoma","volume":"66","author":"Liao","year":"2021","journal-title":"Dig Dis Sci"},{"key":"2025041110180145400_luaf030-B25","doi-asserted-by":"crossref","first-page":"994707","DOI":"10.3389\/fendo.2022.994707","article-title":"The optimal diagnostic criteria of endogenous hyperinsulinemic hypoglycemia based on a large cohort of Chinese patients","volume":"13","author":"Yu","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2025041110180145400_luaf030-B26","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1001\/archinte.1993.00410050082011","article-title":"The molar ratio of insulin to C-peptide. An aid to the diagnosis of hypoglycemia due to surreptitious (or inadvertent) insulin administration","volume":"153","author":"Lebowitz","year":"1993","journal-title":"Arch Intern Med"},{"issue":"5","key":"2025041110180145400_luaf030-B27","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.clinthera.2019.03.009","article-title":"Insulin autoimmune syndrome diagnosis and therapy in a single Chinese center","volume":"41","author":"Yuan","year":"2019","journal-title":"Clin Ther"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/5\/luaf030\/62901374\/luaf030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/5\/luaf030\/62901374\/luaf030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T10:26:45Z","timestamp":1744367205000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf030\/8109780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,3,27]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf030","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,3,27]]},"article-number":"luaf030"}}