[Insulin autoimmune syndrome revealing systemic lupus erythematosus].
A 22-year-old woman was admitted in August 2001 for loss of consciousness due to hypoglycemia. Her serum insulin level during the hypoglycemic episode was high at 121 mU/l (normal range: 5-25 mU/l). She had never received an insulin injection. Insulin antibodies by radioimmunoassay were positive. During hospitalisation, the patient presented clinical and biological features of systemic lupus erythematosus (SLE). Treatment with high-dose corticosteroids and cyclophosphamide resulted in restoration of euglycemia associated with resolution of circulating anti-insulin antibodies and parallel improvement in clinical and laboratory features of SLE.
Service de Médecine Interne, Hôpital Avicienne, CHU, AP-HP, Bobigny.
Samir
S
Rouabhia
Jacky
J
Ramanoelina
Pascal
P
Godmer
Gérard
G
Reach
Jean-Luc
JL
Dutel
Loïc
L
Guillevin
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000097:blood / Q000276:immunology*; D007330:Insulin Antibodies / Q000032:analysis; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D011863:Radioimmunoassay; D013577:Syndrome; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D007328:Insulin; D007330:Insulin Antibodies; D003520:Cyclophosphamide