title: A case of autoimmune hypoglycemia outside Japan: Rare, but in the era of expanding drug-list, important to suspect.
abstract: We are hereby reporting a case of a 72-year-old Indian man, who, in the absence of a detectable tumor, presented with symptomatic hypoglycemia in the postabsorptive state (3-5 h after meal). His serum levels of insulin and C-peptide were very high. He was not taking any hypoglycemic drug. Hypoglycemic episodes completely subsided after withdrawal of pentoprazole and incorporation of small frequent meals in the dietary plan. Six months after the initial presentation, the subject became free of hypoglycemic episodes. Although insulin autoimmune syndrome (IAS) is the third leading cause of spontaneous hypoglycemia in Japan, it is extremely uncommon in the Western Countries. Till 2009, more than 200 cases from Japan and as many as 58 cases outside Asia have been reported. To the best of our knowledge, this is the first case of IAS reported from India.
authors.affiliation: Department of Medicine, Kasturba Hospital, Delhi, India.
authors.forename: Krishan
authors.initials: K
authors.lastname: Gopal
authors.affiliation: Department of Endocrinology, Fortis Hospital, Mohali, India.
authors.forename: Gagan
authors.initials: G
authors.lastname: Priya
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Nandita
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: E P
authors.initials: EP
authors.lastname: Praveen
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khadgawat
keywords: Autoimmune hypoglycemia; Hirata's disease; insulin autoimmune syndrome