title: [Type B insulin resistance syndrome: 3 cases report and literature review].
abstract: OBJECTIVE
  To understand type B insulin resistance syndrome (B-IRS) by reviewing 3 cases from our center and cases from literatures.
  
  
  METHODS
  The clinical characteristics, diagnosis, treatment and follow-up data of the 3 patients with B-IRS were evaluated.
  
  
  RESULTS
  All the 3 patients were middle-aged women with severe hyperglycemia or paradoxical hypoglycemia. The clinical findings were as follows. (1)B-IRS was associated with several autoimmune diseases such as systemic lupus erythematosus (SLE) and sclerosis. (2) The metabolic abnormalities of B-IRS include weight loss, severe hyperinsulinemia, high level of adiponectin, and low level of insulin-like growth factor type 1(IGF-1) and TG. (3)B-IRS was characterized with nonspecific serological disorders (such as leukopenia, thrombocytopenia and hypoalbuminemia) and changes (decreased complements and elevated IgG and/or IgA), and with specific immunological abnormalities[such as high titer of antinuclear antibody(ANA), positive in anti-SSA, anti-SSB and anti-dsDNA antibodies). Positive in anti-insulin receptor antibody was of diagnostic value but not necessary. (4) Treatments include insulin in combination with immunosuppressive therapy. Patients with H. pylori (Hp) infection may be benefit with eradication therapy.
  
  
  CONCLUSIONS
  B-IRS is rare but not difficult to identify. Treatments include therapy of the underlying diseases and high dose of insulin.
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Yang
authors.forename: Jingtao
authors.initials: J
authors.lastname: Dou
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Lyu
authors.forename: Baoan
authors.initials: B
authors.lastname: Wang
authors.forename: Weijun
authors.initials: W
authors.lastname: Gu
authors.forename: Jianming
authors.initials: J
authors.lastname: Ba
authors.forename: Jin
authors.initials: J
authors.lastname: Du
authors.forename: Nan
authors.initials: N
authors.lastname: Jin
authors.forename: Li
authors.initials: L
authors.lastname: Zang
authors.forename: Kang
authors.initials: K
authors.lastname: Chen
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Guo
authors.forename: Yiming
authors.initials: Y
authors.lastname: Mu
authors.forename: Juming
authors.initials: J
authors.lastname: Lu
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood; D001327:Autoimmune Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D007003:Hypoglycemia / Q000175:diagnosis*; D007328:Insulin / Q000627:therapeutic use; D007333:Insulin Resistance; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D008875:Middle Aged
chemical_list: D000974:Antibodies, Antinuclear; D007328:Insulin