Exogenous insulin autoimmune syndrome:A case report and review of literature

作     者：Ling-Ling Xu Jia-Xin Chen Jing-Ping Cheng Ni Luo 

作者机构：Medical CollegeSchool of MedicineWuhan University of Science and TechnologyWuhan 430065Hubei ProvinceChina Department of GerontologyCR&WISCO General Hospital Affiliated to Wuhan University of Science and TechnologyWuhan 430080Hubei ProvinceChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2024年第12卷第9期

页      面：1691-1697页

核心收录：

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

主　　题：Insulin autoimmune syndrome Type 2 diabetes Exogenous insulin Insulin autoantibodies Hypoglycemia Case report 

摘      要：BACKGROUND Insulin autoimmune syndrome(IAS)is a severe manifestation of spontaneous *** is characterized by elevated levels of immune-reactive insulin and highly potent insulin autoantibodies(IAAs),which are induced by endogenous insulin circulating in the *** is distinguished by recurring instances of spontaneous hypoglycemia,the presence of IAA within the body,a substantial elevation in serum insulin levels,and an absence of prior exogenous insulin ***,recent studies show that both conventional insulin and its analogs can induce IAS episodes,giving rise to the notion of nonclassical ***,more attention should be paid to these *** SUMMARY In this case report,we present a rare case of non-classical IAS in an 83-year-old male patient who present with symptoms of a psychiatric *** symptom onset,the patient exhibited Whipple s triad(including hypoglycemia,blood glucose level less than 2.8 mmol/L during onset,and rapid relief of hypoglycemic symptoms after glucose administration).Concurrently,his serum insulin level was significantly elevated,which contradicted his C-peptide *** a comprehensive examination,the patient was diagnosed with exogenous insulin autoimmune *** that the patient had type 2 diabetes mellitus and a history of exogenous insulin use before disease onset,it was presumed that non classical IAS was induced by this *** PubMed database was used to search for previous cases of IAS and non-classical IAS to analyze their characteristics and treatment *** The occurrence of non-classical IAS is associated with exogenous insulin or its analogs,as well as with sulfhydryl *** can be effectively alleviated through the discontinuation of relevant medications,administration of hormones or immunosuppressants,plasma exchange,and lifestyle adjustments.