Autoimmune insulin syndrome.
Initially described in Japan, the autoimmune insulin syndrome is caused by the presence of anti-insulin antibodies in patients who have never received insulin. This syndrome accounts for spontaneous or reactive hypoglycaemia with very high levels of total immuno-reactive insulin. Discordance between the levels of immunoreactive insulin and C peptide indicate the possible presence of anti-insulin antibodies; this can avoid an incorrect diagnosis of insulinoma. These autoimmune hypoglycaemias often present a difficult diagnostic problem in distinguishing them from factitious hypoglycaemia. The course of the autoimmune insulin syndrome is usually favourable, with a spontaneous rapid diminution of the levels of anti-insulin antibodies. The reasons for the appearance of anti-insulin antibodies and the exact mechanisms of the hypoglycaemia remain uncertain. However, the frequent association of the autoimmune insulin syndrome with certain autoimmune diseases suggest a common immune dysfunction. Drugs containing a sulphydryl group have been implicated in the aetiology of this syndrome.
Archambeaud-Mouveroux
F
F
Service de Médecine Interne B-Endocrinologie, CHU, Limoges, France.
Huc
M C
MC
Nadalon
S
S
Fournier
M P
MP
Canivet
B
B
D001327:Autoimmune Diseases / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D007330:Insulin Antibodies / Q000032:analysis*; D011379:Prognosis
D007330:Insulin Antibodies