title: Severe hypoglycaemia in a person with insulin autoimmune syndrome accompanied by insulin receptor anomaly type B.
abstract: 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.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Fukita Health University, School of Medicine, Toyoake, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: M
authors.initials: M
authors.lastname: Itoh
authors.forename: J
authors.initials: J
authors.lastname: Hanashita
authors.forename: T
authors.initials: T
authors.lastname: Itoi
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: S
authors.initials: S
authors.lastname: Imamura
authors.forename: N
authors.initials: N
authors.lastname: Hayakawa
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Y
authors.initials: Y
authors.lastname: Uchigata
authors.forename: N
authors.initials: N
authors.lastname: Oda
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D006684:HLA-DR Antigens; D007328:Insulin; D007330:Insulin Antibodies; D011972:Receptor, Insulin