title: Autoimmune insulin syndrome in a patient with progressive systemic sclerosis receiving penicillamine.
abstract: 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.
authors.affiliation: Division of Endocrinology, Fundación Jimenz Diaz, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Herranz
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: C
authors.initials: C
authors.lastname: Grande
authors.forename: A
authors.initials: A
authors.lastname: Suarez
authors.forename: J
authors.initials: J
authors.lastname: Martinez-Ara
authors.forename: L F
authors.initials: LF
authors.lastname: Pallardo
authors.forename: A
authors.initials: A
authors.lastname: Gómez-Pan
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose; D007328:Insulin; D010396:Penicillamine