scholarly journals Insulin autoimmune syndrome as a cause of recurrent hypoglycemia in a carbimazole user: a case report from Nepal

2019 ◽  
Vol Volume 12 ◽  
pp. 29-32 ◽  
Author(s):  
Vivek Pant ◽  
Bijay Bhandari ◽  
Suman Baral ◽  
Sangha Ratna Bajracharya
2015 ◽  
Vol 9 (2) ◽  
pp. 169 ◽  
Author(s):  
Antonio Balestrieri ◽  
Elena Magnani ◽  
Cecilia Ragazzini ◽  
Giampiero Pasini

Insulin autoimmune syndrome (IAS) is a rare syndrome characterized by fasting or postprandial hypoglycemia, high levels of anti-insulin antibodies and high concentration of total serum immunoreactive insulin. It is relatively known in Japan, rare in remaining Asia and it is extremely uncommon in Western countries, being characterized by a different race-related incidence and associated with HLADR4 alleles. Usually IAS is related to particular drugs, or to autoimmune, rheumatologic or hematological diseases, while it is very rare as a primary form. Here we described a case of an Italian woman affected by a primary form of Hirata syndrome.


2018 ◽  
Vol 62 (5) ◽  
pp. 566-570 ◽  
Author(s):  
Mariella Zaiden Rezende Reis ◽  
Virgínia Oliveira Fernandes ◽  
Eveline Gadelha Pereira Fontenele ◽  
Ana Paula Abreu Martins Sales ◽  
Renan Magalhães Montenegro ◽  
...  

1992 ◽  
Vol 92 (6) ◽  
pp. 681-685 ◽  
Author(s):  
Henry B. Burch ◽  
Stephen Clement ◽  
Michael S. Sokol ◽  
Frank Landry

2013 ◽  
Vol 29 (1) ◽  
pp. 250-254 ◽  
Author(s):  
Sophia L. Wong ◽  
Anne Priestman ◽  
Daniel T. Holmes

2017 ◽  
Vol 16 (4) ◽  
pp. 230-234 ◽  
Author(s):  
Xiu Feng ◽  
Lu Yuan ◽  
Yun Hu ◽  
Yunqing Zhu ◽  
Fan Yang ◽  
...  

2020 ◽  
Vol 20 (8) ◽  
pp. 1355-1362 ◽  
Author(s):  
Yihong Jiang ◽  
Lihua Wang ◽  
Fanghong Shi ◽  
Huan Zhou ◽  
Jun Zheng ◽  
...  

Background: Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia that is characterized by hyperinsulinemia, hypoglycemia, and a high autoantibody titer. About 50% of patients with IAS have taken a medication containing sulfhydryl (-SH) groups. We present a case of IAS that developed after taking clopidogrel, a drug with an active metabolite that contains an SH-group. Case report: IAS was suspected in a 63-year-old Chinese man because of high concentrations of insulin and C-peptide during hypoglycemic episodes, and positivity for anti-insulin autoantibody (IAA). During his first episode of hypoglycemia, no trigger medication was identified and prednisone therapy was effective. However, imaging examination revealed a colonic carcinoma and the patient was discharged to undergo surgery. He had no episodes of hypoglycemia for 10 weeks after discontinuation of the prednisone, but then hypoglycemia recurred. A review of his medication revealed that he had taken a 10-day course of clopidogrel just before the recurrence. Therefore, a specialized multidisciplinary team consisting of endocrinologists, dieticians, and clinical pharmacists took charge of his management. Prednisone therapy was restarted and tapered off over 16 weeks. The patient also consumed small, frequent, low-carbohydrate meals and was instructed to avoid trigger medications. No further episodes of hypoglycemia were detected. His insulin and C-peptide concentrations and his anti-IAA index normalized during the follow-up period. Conclusion: SH-group-containing drugs might induce or exacerbate hypoglycemia in patients with a history of IAS. Furthermore, patients with IAS can benefit from multidisciplinary team management. We suggest herein an evaluation process for patients suspected of IAS.


2004 ◽  
Vol 122 (4) ◽  
pp. 178-180 ◽  
Author(s):  
Rodrigo Oliveira Moreira ◽  
Giovanna Aparecida Balarini Lima ◽  
Patrícia Carla Batista Peixoto ◽  
Maria Lucia Fleiuss Farias ◽  
Mario Vaisman

CONTEXT: Insulin autoimmune syndrome (IAS, Hirata disease) is a rare cause of hypoglycemia in Western countries. It is characterized by hypoglycemic episodes, elevated insulin levels, and positive insulin antibodies. Our objective is to report a case of IAS identified in South America. CASE REPORT: A 56-year-old Caucasian male patient started presenting neuroglycopenic symptoms during hospitalization due to severe trauma. Biochemical evaluation confirmed hypoglycemia and abnormally high levels of insulin. Conventional imaging examinations were negative for pancreatic tumor. Insulin antibodies were above the normal range. Clinical remission of the episodes was not achieved with verapamil and steroids. Thus, a subtotal pancreatectomy was performed due to the lack of response to conservative treatment and because immunosuppressants were contraindicated due to bacteremia. Histopathological examination revealed diffuse hypertrophy of beta cells. The patient continues to have high insulin levels but is almost free of hypoglycemic episodes.


Diabetes Care ◽  
2011 ◽  
Vol 34 (9) ◽  
pp. e146-e146 ◽  
Author(s):  
Enrico Bresciani ◽  
Anna Bussi ◽  
Elena Bazzigaluppi ◽  
Gianpaolo Balestrieri

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