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

World Journal of Clinical Cases 2024年第9期12卷 1691-1697页

作者： Ling-Ling Xu Jia-Xin Chen Jing-Ping Cheng Ni Luo Medical College School of MedicineWuhan University of Science and TechnologyWuhan 430065Hubei ProvinceChina Department of Gerontology CR&WISCO General Hospital Affiliated to Wuhan University of Science and TechnologyWuhan 430080Hubei ProvinceChina

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.

关键词： insulin autoimmune syndrome Type 2 diabetes Exogenous insulin insulin autoantibodies Hypoglycemia Case report

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insulin autoimmune syndrome： 73 Cases of Clinical Analysis

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Chinese Medical Journal 2015年第17期128卷 2408-2409页

作者： Yun-Lin Wang Pei-Wei Yao Xiao-Ting Zhang Zhuo-Zhang Luo Pei-Qiang Wu Fang Xiao Department of Internal Medicine Second People's Hospital of Foshan Foshan Guangdong 528000 China

autoimmune hypoglycemia, also called insulin autoimmune syndrome （IAS）, was first reported by Hirata and Ishizu in 1972 in Japan. IAS is characterized by the diagnostic criteria of spontaneous hypoglycemia without evidence of exogenous insulin administration, high levels of total immunoreactive insulin, and the presence of a high titer of insulin autoantibodies.

关键词： Clinical Features insulin autoimmune syndrome Treatments

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