[Lupus, insulin-resistant diabetes and acanthosis nigricans (author's transl)].
The authors report the case of a 22-year-old Guatemalan in whom lupus was diagnosed 8 months after a second pregnancy. The diagnosis of lupus met the criteria of the ARA: Raynaud's syndrome, alopecia, arthralgia, thrombophlebitis, facial erythema, antinuclear factor at 1/100, Farr at 75 p. 100 and immunofluorescent demonstration of IgM binding in healthy skin. Two months after the beginning of the lupus, there was onset of insulin-resistant ketosic diabetes without overweight. The serum insulin was 1.140 mu U/ml. Acanthosis nigricans was noted and confirmed by a biopsy. Insulin-resistance can be attributed to anti-membrane receptor antibodies titrating at 1/200 (R. Khan). The short-term progress of the disease was favorable on corticosteroid treatment. Insulin could be stopped, but high insulin serum levels persisted. This case meets criteria for type B as defined by Flier, Khan and Roth, and is the first European case of lupus with a complete presentation. Short-term progress was favorable, and there is no evidence to affirm that there will be a tardive progression towards hypoglycemia which is, however, possible due to the persistence of elevated serum insulin levels.
D000052:Acanthosis Nigricans / Q000150:complications* / Q000378:metabolism; D000208:Acute Disease; D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000276:immunology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D011972:Receptor, Insulin / Q000276:immunology
D001323:Autoantibodies; D011972:Receptor, Insulin
[Lupus érythémateux aigu disséminé, diabète insulino-résistant et acanthosis nigricans. A propos d'une observation.