Síndrome de hipoglicemia autoinmune: Primeros casos en Chile

Lanas, Alejandra; Paredes, Ana; Espinosa, Consuelo; Caamaño, Egardo; Pérez-Bravo, Francisco; Pinto, Rodrigo Serpa; Íñiguez, Germán; Martínez, Darío; Soto, Néstor

doi:10.4067/s0034-98872015000700016

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…For most patients with IAS, the symptoms would be relieved quickly after stopping insulin medication. However, our patient with T1DM was dependent on insulin treatment, and when he suffered from HC, most physicians tended to reduce or stop insulin for a while 8,9,[15][16][17][18][19] , which then led to hyperglycemia and DKA. This cycle of HC alternating with DKA happened many times, but was concealed behind the T1DM characteristic of irregular blood glucose levels.…”

Section: Discussionmentioning

confidence: 91%

Recurrent hypoglycemic coma and diabetic ketoacidosis caused by insulin antibody. A rare case of type 1 diabetes mellitus

Kong

Zhang

et al. 2022

Rev. méd. Chile

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Insulin antibodies (IAs) induced by exogenous insulin rarely cause hypoglycemia. However, insulin autoantibodies (IAAs) in insulin autoimmune syndrome (IAS) can cause hypoglycemia. The typical manifestations of IAS are fasting or postprandial hypoglycemia, elevated insulin level, decreased C-peptide levels, and positive IAA. We report a 45-year-old male with type 1 diabetes mellitus (T1DM) treated with insulin analogues suffering from recurrent hypoglycemic coma and diabetic ketoacidosis (DKA). His symptoms were caused by exogenous insulin and were similar to IAS. A possible reason was that exogenous insulin induced IA. IA titers were 61.95% (normal: < 5%), and the concentrations of insulin and C-peptide were > 300 mU/L and < 0.02 nmol/L when hypoglycemia occurred. Based on his clinical symptoms and other examinations, he was diagnosed with hyperinsulinemic hypoglycemia caused by IA. His symptoms improved after changing insulin regimens from insulin lispro plus insulin detemir to recombinant human insulin (Gensulin R) and starting prednisone.

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Section: Discussionmentioning

confidence: 91%

Recurrent hypoglycemic coma and diabetic ketoacidosis caused by insulin antibody. A rare case of type 1 diabetes mellitus

Kong

Zhang

et al. 2022

Rev. méd. Chile

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Hypoglycemia due to Insulin Autoimmune Syndrome: A rare cause not to be forgotten

Alam

Ozair

Ahmad

2016

Journal of Clinical and Translational Endocrinology: Case Repor

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Insulin Autoimmune Syndrome: A Systematic Review

Lin

Chen

Ning

2023

International Journal of Endocrinology

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Insulin autoimmune syndrome (IAS) is a rare endocrine disorder characterized by recurrent episodes of severe hypoglycemia, markedly elevated serum insulin, and positive insulin autoantibodies. In recent years, various countries have reported it one after another. It can be seen that we must pay attention to this disease. The diagnosis of IAS is challenging, requiring a careful workup aimed at excluding other causes of hyperinsulinemic hypoglycemia. High levels of insulin autoantibodies are found in patients, and C-peptide is not parallel to insulin, which could be diagnostic. IAS is a self-limiting disease with a good prognosis. Its treatment mainly includes symptomatic supportive treatment, such as adjusting the diet and using acarbose and other drugs to delay the absorption of glucose to prevent hypoglycemia. For patients with severe symptoms, available treatments may include drugs that reduce pancreatic insulin secretion (such as somatostatin and diazoxide), immunosuppressants (glucocorticoids, zaprin, and rituximab), and even plasma exchange to remove autoantibodies from the body. This review provides a comprehensive analysis of the epidemiology, pathogenesis, clinical manifestations, diagnosis and identification, and monitoring and treatment management of IAS.

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Síndrome de hipoglicemia autoinmune: Primeros casos en Chile

Abstract: Insulin autoimmune syndrome (IAS) is characterized by spontaneous (Rev Med Chile 2015; 143: 938-942)

Cited by 5 publications

References 17 publications

Recurrent hypoglycemic coma and diabetic ketoacidosis caused by insulin antibody. A rare case of type 1 diabetes mellitus

Recurrent hypoglycemic coma and diabetic ketoacidosis caused by insulin antibody. A rare case of type 1 diabetes mellitus

Hypoglycemia due to Insulin Autoimmune Syndrome: A rare cause not to be forgotten

Insulin Autoimmune Syndrome: A Systematic Review

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