Severe hypoglycaemia in a person with insulin autoimmune syndrome accompanied by insulin receptor anomaly type B.
OBJECTIVE
A rare case of the insulin autoimmune syndrome (IAS) accompanied by insulin receptor anomaly is reported.


METHODS
Antibodies to insulin and insulin receptor were determined in the patient with severe hypoglycaemia before and after the treatment with prednisolone.


RESULTS
Titers of antibody to insulin and insulin receptors were 73.0% and 41.5%, respectively. Drug-induced lymphocyte stimulation tests were all negative for the suspicious drugs. Her HLA-DR was DRB1*0403/04051. Following steroid therapy, the formation of antibodies was suppressed and alleviated her symptoms. Scatchard analysis yielded findings specific to polyclonal antibodies.


CONCLUSIONS
The changes in autoantibodies resulted in alleviation of the hypoglycemic symptoms as a result of steroid therapy.
Kato
T
T
Division of Endocrinology and Metabolism, Department of Internal Medicine, Fukita Health University, School of Medicine, Toyoake, Aichi, Japan.
Itoh
M
M
Hanashita
J
J
Itoi
T
T
Matsumoto
T
T
Ono
Y
Y
Imamura
S
S
Hayakawa
N
N
Suzuki
A
A
Mizutani
Y
Y
Uchigata
Y
Y
Oda
N
N
D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006684:HLA-DR Antigens; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007328:Insulin / Q000378:metabolism*; D007330:Insulin Antibodies / Q000378:metabolism; D000078790:Insulin Secretion; D008213:Lymphocyte Activation / Q000187:drug effects; D011972:Receptor, Insulin / Q000378:metabolism; D016896:Treatment Outcome
D001786:Blood Glucose; D006684:HLA-DR Antigens; D007328:Insulin; D007330:Insulin Antibodies; D011972:Receptor, Insulin