Insulin autoimmune syndrome. (4th June 2020)

• Record Type: Journal Article
• Authors: Yukina, Marina; Nuralieva, Nurana; Solovyev, Maksim; Troshina, Ekaterina; Vasilyev, Evgeny
• Is Part Of: Endocrinology, diabetes & metabolism case reports. (2020)
• Publication Date: 2020-06-04
• Subjects: Adult -- Female -- White -- Russian Federation; Pancreas -- Diabetes -- Insulin -- Insulin autoimmune syndrome -- Hypoglycaemia; Hypoglycaemia -- Anxiety -- Dizziness -- Anti-insulin antibodies -- Insulin -- Proinsulin -- Glucose (blood) -- Glucose (blood, fasting) -- Glucose (blood, postprandial) -- Exercise tolerance -- Glucose tolerance (oral) -- Protein electrophoresis -- Immunoglobulin A -- Albumin -- Urinalysis -- HOMA -- HLA genotyping -- Thyroid ultrasonography -- C-peptide (blood) -- Insulin (fasting) -- alpha-lipoic acid* -- Thioctic acid*; New disease or syndrome: presentations/diagnosis/management -- June -- 2020; Endocrinology -- Periodicals; Diabetes -- Periodicals; Diabetes Mellitus; Endocrinology; Diabetes; Endocrinology; Case Reports; Periodicals; Periodicals; 616.4
• DOI: 10.1530/EDM-19-0159
• Languages: English
• ISSNs: 2052-0573

Abstract

Abstract : Summary: Insulin autoimmune syndrome (Hirata's disease) is a disorder caused by development of autoantibodies to insulin and manifested by hypoglycaemic syndrome. The overwhelming majority of physicians do not include it in the differential diagnosis of hypoglycaemic states because of a misconception of an extremely low prevalence of this condition. This results in unnecessary drug therapy and unjustified surgical interventions in patients that otherwise would be successfully treated conservatively. This disease is strongly associated with certain alleles of the HLA gene. In most cases, this condition develops in predisposed individuals taking drugs containing sulfhydryl groups. Formation of autoantibodies to insulin may be observed in patients with other autoimmune disorders, as well as in those with multiple myeloma or monoclonal gammopathy of undetermined significance. This paper presents the first Russian case report of insulin autoimmune syndrome in an adult patient. Learning points: Insulin autoimmune syndrome, Hirata's disease, anti-insulin antibodies, and hypoglycaemia.