Insulin autoimmunity as a cause of hypoglycemia.
"Autoimmune" hypoglycemia is a syndrome consisting of fasting hypoglycemia, hyperinsulinemia, and insulin-binding antibodies in a patient who has never been exposed to exogenous insulin. The stimulus for insulin-antibody formation and the mechanism of the hypoglycemia in this condition remain unknown. Three patients with this rare syndrome had severe hypoglycemia of limited duration. Two had received a drug containing a sulfhydryl group (methimazole and penicillamine) as treatment for an autoimmune disorder (Graves' disease and rheumatoid arthritis, respectively). A third patient who underwent surgery for a suspected insulinoma was found to have pancreatic beta cell hyperplasia. Drugs containing a sulfhydryl group may have a role in the etiology of the syndrome. Additionally, our findings suggest a relationship between circulating insulin antibodies and beta cell hyperplasia.
D001323:Autoantibodies / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007003:Hypoglycemia / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D007330:Insulin Antibodies / Q000502:physiology*; D007340:Insulinoma / Q000473:pathology; D007515:Islets of Langerhans / Q000276:immunology / Q000473:pathology; D008297:Male; D008713:Methimazole / Q000009:adverse effects; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology; D010396:Penicillamine / Q000009:adverse effects; D013577:Syndrome
D001323:Autoantibodies; D007330:Insulin Antibodies; D008713:Methimazole; D010396:Penicillamine