Autoimmune insulin syndrome in a patient with progressive systemic sclerosis receiving penicillamine.
The case of a patient with progressive systemic sclerosis, who developed hypoglycaemia and insulin autoantibodies, is described. Repeated blood glucose measurements showed levels less than 2.8 mmol/l. High immunoreactive insulin levels, with undetectable free insulin, led to the discovery of anti-insulin antibodies in the patient's serum. He had no history of exogenous insulin use and was receiving penicillamine treatment. A double mechanism for the autoimmune insulin syndrome in this case is proposed: acting in a patient with increased humoral immunoresponsiveness, penicillamine might have induced the development of insulin autoantibodies.
Herranz
L
L
Division of Endocrinology, Fundación Jimenz Diaz, Madrid, Spain.
Rovira
A
A
Grande
C
C
Suarez
A
A
Martinez-Ara
J
J
Pallardo
L F
LF
Gómez-Pan
A
A
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000139:chemically induced*; D001786:Blood Glucose / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000276:immunology*; D008297:Male; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use
D001323:Autoantibodies; D001786:Blood Glucose; D007328:Insulin; D010396:Penicillamine