title: Insulin autoimmune syndrome caused by an adhesive skin patch containing loxoprofen-sodium.
abstract: A 62-year-old woman complained of repeated hypoglycemic events. A 75 g oral glucose tolerance test (75 gOGTT) showed a marked increase in the plasma insulin level and impaired glucose tolerance. The patient exhibited a high titer of plasma anti-insulin autoantibodies. Her diagnosis was insulin autoimmune syndrome (IAS). Following the cessation of loxoprofen-sodium (LOXs), she experienced no further hypoglycemic episodes. However, the hypoglycemic attacks recurred following the accidental readministration of LOXs in an adhesive skin patch. Considering the changes in the titer of anti-insulin autoantibodies, the repeated 75 gOGTT and the repeated Scatchard analysis, we determined LOXs to be the cause of the IAS and evaluated the characteristics of the autoantibodies.
authors.affiliation: Department of Endocrinology and Metabolism, Komatsu Municipal Hospital, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Okazaki-Sakai
authors.forename: Sachiko
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Yagi
authors.forename: Takanobu
authors.initials: T
authors.lastname: Wakasugi
authors.forename: Yoshiyu
authors.initials: Y
authors.lastname: Takeda
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000279:Administration, Cutaneous; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000209:etiology* / Q000276:immunology; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology / Q000276:immunology; D007328:Insulin / Q000097:blood / Q000276:immunology; D007330:Insulin Antibodies / Q000097:blood*; D008875:Middle Aged; D010666:Phenylpropionates / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001323:Autoantibodies; D001786:Blood Glucose; D007328:Insulin; D007330:Insulin Antibodies; D010666:Phenylpropionates; C040656:loxoprofen