Insulin Autoimmune Syndrome in a 25-Year-Old, Previously Healthy Kuwaiti Man

Abstract

Insulin autoimmune syndrome (IAS) is a disease characterized by hyperinsulinaemic hypoglycaemia associated with autoantibodies against endogenous insulin. We have described a case of a 25-year-old, previously healthy Kuwaiti man who was admitted to the Mubarak Al-Kabeer hospital with a history of recurrent hypoglycaemia. e patient revealed that he had taken several di erent injectable anabolic steroids and growth hormone with oral amino acids and other tablets (fat burners) for bodybuilding in the last two months. He denied knowingly using insulin or insulin analogues. e patient had elevated fasting insulin level (>301 uIU/mL) and elevated insulin autoantibodies (>100.0 IU/mL). A er appropriate work-up, he was diagnosed with IAS. A er treatment with prednisolone (1 mg/kg/day), the patient had complete recovery. In patients with repeated hypoglycaemia, IAS should be considered in the di erential diagnosis. Glucocorticoid therapy can be e ective for the treatment of hypoglycaemia in patients with IAS.

Insulin Autoimmune Syndrome: A Systematic Review

“…A few cases of insulin autoimmunity manifested as hypoglycemia after repeated diabetic ketoacidosis [ 47 ]. In addition, some patients with recurrent hypoglycemia and a long course of the disease may gain weight due to frequent eating [ 48 , 49 ].…”

Insulin autoimmune syndrome: A rare cause of hypoglycemia

“…Insulin autoimmune syndrome should be considered in differential for adult patient presenting with hypoglycemia and taking dietary supplements. [ 7 ] High insulin and C-peptide levels with elevated insulin autoantibodies are diagnostic of IAS. 8 Once diagnosed, the treatment is with immunosuppressant or steroids and regular follow-up must be assured until antibodies level normalized.…”