Erythrocyte insulin receptor in insulin autoimmune syndrome. Effects of corticosteroid therapy.

Ohtsuka, Yoshinori; Kondo, Takahito; Shimada, Michiro; Murakami, Kazuhiro; Ide, Hajime; Kawakami, Yoshikazu

doi:10.1620/tjem.151.181

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…Furthermore, corticosteroids and immunosuppressant therapy could reduce levels of insulin autoantibodies. [ 22 , 24 ] Acarbose, diazoxide, octreotide, pancreatectomy, and plasmapheresis are other choices for the treatment of IAS. [ 25 – 27 ] The patient did not experience any further hypoglycemic episodes after the abortion and discontinuation of methimazole.…”

Section: Discussionmentioning

confidence: 99%

Insulin autoimmune syndrome in a pregnant female

Zeng

Tang²,

Hu³

et al. 2017

Medicine

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Rationale:Insulin autoimmune syndrome (IAS) is an uncommon disorder characterized by hyperinsulinemic hypoglycemia related to insulin-binding autoantibodies. To the best of our knowledge, we report the first case of a pregnant female with IAS.Patient concerns:The 26-year-old patient with Graves disease and 10 weeks pregnant developed IAS after approximately 6 months treatment with methimazole. The patient exhibited recurrent spontaneous hypoglycemia.Diagnoses:On evaluation, laboratory findings detected both high fasting insulin (>1000 mIU/L) and insulin autoantibodies. An oral glucose tolerance test showed elevated insulin concentrations with disproportionately elevated C-peptide levels. The imaging study showed nomasslesionsinthepancreas,and the patient was clinically diagnosed with IAS.Interventions:The patient had an abortion, discontinued methimazole and switched to oral prednisone (30 mg once daily) and propylth- iouracil (100 mg 3 times daily) for 3 months.Outcomes:At the 3-month follow-up visit, hypoglycemic episodes had disappeared and insulin antibody levels were no longer detectable.Lessons:We have described this case and reviewed the relevant literature concerning diagnosis and treatment of IAS. Importantly, this case indicates that clinicians should view pregnancy as another factor of hypoglycemia in IAS.

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Section: Discussionmentioning

confidence: 99%

Insulin autoimmune syndrome in a pregnant female

Zeng

Tang²,

Hu³

et al. 2017

Medicine

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“…In addition, glucocorticoids and immunosuppressants may be useful as adjuvant therapies for IAS control (13). A Japanese study showed that corticosteroid therapy reduced the amount of insulin receptor binding sites and avoided hypoglycemic attacks, suggesting the usefulness of corticosteroid therapy in the treatment of IAS (14). In the present case, a small dose of prednisone was used, with an initial dosage of 10 mg QD and maintaining at 5 mg QD.…”

Section: Discussionmentioning

confidence: 79%

Insulin-induced autoimmune syndrome: A case report

Chu

Zheng

Liu

et al. 2016

Experimental and Therapeutic Medicine

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Insulin autoimmune syndrome (IAS) is a disease characterized by hyperinsulinemic hypoglycemia associated with autoantibodies against endogenous insulin. A 56-year-old man was admitted to Ningbo First Hospital for the treatment of spontaneous hypoglycemia. He was found to have elevated fasting insulin level (>1,000 mIU/l) and presence of insulin autoantibodies, and after appropriate workup, was diagnosed with IAS. After treating with prednisone for 2 months, his insulin level started decreasing. In patients with repeated hypoglycemia, IAS should be considered in the differential diagnosis. Prednisone may be effective for the treatment of hypoglycemia in patients with IAS.

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“…3,4,17,18 Previous studies have shown that glucocorticoid therapy reduces the amount of insulin receptor binding sites and suppresses insulin antibody production. 19,20 In the present case, a small dose of prednisone at an initial dosage of 30 mg daily was administered. The patient achieved remission and experienced no further hypoglycemic episodes.…”

Section: Discussionmentioning

confidence: 87%

Long-term follow-up of methimazole-associated insulin autoimmune syndrome: a rare case report

Sun

Lin

et al. 2023

J Int Med Res

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Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia and is characterized by the presence of insulin autoantibodies and fasting or late postprandial hypoglycemia. The number of reports on the association of long-term follow-up of IAS in China is limited. We herein report a case of drug-induced IAS in a 44-year-old Chinese woman. She had been taking methimazole for Graves’ disease and had subsequently presented with recurrent hypoglycemic episodes. Laboratory assessments on admission revealed that her serum insulin level was significantly elevated (>1000 µIU/mL) and that she was positive for serum insulin autoantibody, leading to a diagnosis of IAS. Human leukocyte antigen DNA typing identified *04:06/*09:01:02, an immunogenetic determinant associated with IAS. After treatment with prednisone for 2 months, the hypoglycemic episodes disappeared, her serum insulin level gradually declined, and her insulin antibody levels became negative. Clinicians should be aware of the potential for methimazole to trigger autoimmune hypoglycemia in people with a genetic predisposition.

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Erythrocyte insulin receptor in insulin autoimmune syndrome. Effects of corticosteroid therapy.

Cited by 7 publications

References 18 publications

Insulin autoimmune syndrome in a pregnant female

Insulin autoimmune syndrome in a pregnant female

Insulin-induced autoimmune syndrome: A case report

Long-term follow-up of methimazole-associated insulin autoimmune syndrome: a rare case report

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