title: Autoimmune insulin syndrome.
abstract: 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.
authors.affiliation: Service de Médecine Interne B-Endocrinologie, CHU, Limoges, France.
authors.forename: F
authors.initials: F
authors.lastname: Archambeaud-Mouveroux
authors.forename: M C
authors.initials: MC
authors.lastname: Huc
authors.forename: S
authors.initials: S
authors.lastname: Nadalon
authors.forename: M P
authors.initials: MP
authors.lastname: Fournier
authors.forename: B
authors.initials: B
authors.lastname: Canivet
mesh_terms: D001327:Autoimmune Diseases / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D007330:Insulin Antibodies / Q000032:analysis*; D011379:Prognosis
chemical_list: D007330:Insulin Antibodies