{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:53:12Z","timestamp":1753883592470,"version":"3.41.2"},"reference-count":30,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report here the third case of Hirata syndrome from Peru, a 65-year-old woman who presented to the emergency room with obtunded sensorium caused by severe hypoglycemia secondary to endogenous autoimmune hyperinsulinism after 1 year of many episodes of postprandial hypoglycemia. Six months before admission, both arterial hypertension and Graves\u2019 disease were disclosed, receiving nebivolol 5\u2005mg day only. Eight days before admission, flavonoids were prescribed for mild venous insufficiency. Treatment of hypoglycemia included drug withdrawal, a fractionated diet with low-glycemic index carbohydrates, prednisone, and radioactive iodine for definitive treatment of Graves\u2019 disease, with resolution of the condition 6 months later. She presented unilateral avascular necrosis of the hip as a complication of corticosteroid therapy. We did not identify any trigger factor for hypoglycemia besides Graves\u2019 disease as she did not receive any drug at hypoglycemia onset. We recommend checking for anti-insulin antibodies in cases of endogenous hyperinsulinism associated with an autoimmune disease, despite the absence of any drug treatment.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf133","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T03:15:21Z","timestamp":1751166921000},"source":"Crossref","is-referenced-by-count":0,"title":["Hirata Syndrome in a Woman With Graves\u2019 Disease Without Exposure to Thionamides and Summary of Cases from South America"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0102-620X","authenticated-orcid":false,"given":"Naysha Yanet","family":"Chavez Rondinel","sequence":"first","affiliation":[{"name":"Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia , 150135 Lima ,","place":["Per\u00fa"]},{"name":"Departamento de Endocrinolog\u00eda, Hospital Nacional Cayetano Heredia , 150135 Lima ,","place":["Per\u00fa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-5632","authenticated-orcid":false,"given":"Grecia Almendra","family":"Caycho Gamarra","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia , 150135 Lima ,","place":["Per\u00fa"]},{"name":"Departamento de Endocrinolog\u00eda, Hospital Nacional Cayetano Heredia , 150135 Lima ,","place":["Per\u00fa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4105-4457","authenticated-orcid":false,"given":"Jaime Eduardo","family":"Villena Ch\u00e1vez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia , 150135 Lima ,","place":["Per\u00fa"]},{"name":"Departamento de Endocrinolog\u00eda, Hospital Nacional Cayetano Heredia , 150135 Lima 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