title: Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia.
abstract: A 66-year-old man with type 2 diabetes on hemodialysis treatment was admitted due to poor glycemic control. His serum insulin level and the (125)I-insulin binding rate were extremely high with an increased eosinophil count, although he did not have an allergic reaction to insulin or an elevation of specific IgE for human insulin. A Scatchard analysis revealed that the patient's insulin antibodies had a low affinity constant and a high binding capacity. Prednisolone administration decreased the eosinophil count and (125)I-insulin binding rate; accordingly, the glycemic control improved. Corticosteroid therapy may be a potent therapeutic strategy for insulin antibody-induced severe insulin resistance with eosinophilia.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Japan.
authors.forename: Makiyo
authors.initials: M
authors.lastname: Takaya
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Nagao
authors.forename: Shuji
authors.initials: S
authors.lastname: Takemitsu
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sugihara
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oikawa
mesh_terms: D000368:Aged; D000906:Antibodies / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000276:immunology*; D004802:Eosinophilia / Q000188:drug therapy / Q000276:immunology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology; D007330:Insulin Antibodies / Q000097:blood*; D007333:Insulin Resistance; D007958:Leukocyte Count; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D006435:Renal Dialysis
chemical_list: D000906:Antibodies; D001786:Blood Glucose; D005938:Glucocorticoids; D007330:Insulin Antibodies; D011239:Prednisolone