Insulin Autoimmune Syndrome – An After-Meal Roller Coaster Ride
Keywords:
Hypoglycemia, Endogenous Hyperinsulinism, Insulin AntibodiesAbstract
Hypoglycemic disorders are rare in persons without diabetes, and clinical evaluation to identify its etiology can be challenging. We present a case of insulin autoimmune syndrome induced by carbimazole in a middle-aged Chinese man with underlying Graves’ disease, which was managed conservatively with a combination of dietary modification and alpha-glucosidase inhibitor.
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Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94(3):709-28. PMID: 19088155. https://doi.org/10.1210/jc.2008-1410.
Kittah NE, Vella A. Management of endocrine disease: Pathogenesis and management of hypoglycemia. Eur J Endocrinol. 2017;177(1):R37-47. PMID: 28381450. https://doi.org/10.1530/EJE-16-1062.
Cappellani D, Macchia E, Falorni A, Marchetti P. Insulin autoimmune syndrome (Hirata Disease): A comprehensive review fifty years after its first description. Diabetes Metab Syndr Obes. 2020;13:963-78. PMID: 32308449. PMCID: PMC7136665. https://doi.org/ 10.2147/DMSO.S219438.
Haverkamp GLG, Ijzerman RG, Kooter J, Krul-Poel YHM. The after-dinner dip. N Engl J Med. 2022;386(22):2130-6. PMID: 35648706. https://doi.org/10.1056/NEJMcps2106883.
Censi S, Mian C, Betterle C. Insulin autoimmune syndrome: From diagnosis to clinical management. Ann Transl Med. 2018;6(17):335. PMID: 30306074. PMCID: PMC6174196. https://doi.org/10.21037/atm.2018.07.32.
Church D, Cardoso L, Kay RG, et al. Assessment and management of anti-insulin autoantibodies in varying presentations of insulin autoimmune syndrome. J Clin Endocrinol Metab. 2018;103(10):3845-55. PMID: 30085133. PMCID: PMC6179165. https://doi.org/10.1210/jc.2018-00972.
Zhu Q, Zhao H, Qiu W, et al. Case report: Recurrent autoimmune hypoglycemia induced by non-hypoglycemic medications. Front Immunol. 2022;13:855350. PMID: 35935967. PMCID: PMC9352986. https://doi.org/10.3389/fimmu.2022.855350.
Praveen VP, Bhavani N, Jayakumar RV, et al. Autoantibodies to insulin and dysglycemia in people with and without diabetes: An underdiagnosed association. Clin Diabetes. 2016;34(3):164-7. PMID: 27621535. PMCID: PMC5019007. https://doi.org/10.2337/diaclin.34.3.164.
Tadakamalla Y, NS Praveen, Sethi BK, Gowde CDK. Treatment of insulin autoimmune syndrome - a tri-prong approach. J Diabetes Treat. 2021;6:1094. https://doi.org/10.29011/2574-7568.001094.
Wong SL, Priestman A, Holmes DT. Recurrent Hypoglycemia from Insulin Autoimmune Syndrome. J Gen Intern Med. 2014;29(1):250-4. PMID: 23979685. PMCID: PMC3889959. https://doi.org/10.1007/s11606-013-2588-9.
Peters C, Nirmalaraj K. Long-Term Prevention of Hypoglycemia by Conservatively Managed Insulin Autoimmune Syndrome. AACE Clinical Case Rep. 2016;2(3):e260-3. https://doi.org/10.4158/EP15991.CR.
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Copyright (c) 2023 Chee Koon Low, Hui Chin Wong, Saraswathy Apparow, Sy Liang Yong
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