title: Two Sisters with Graves' Disease and Similar Clinical Features who Tested Positive for Anti-insulin Antibodies after Thiamazole Treatment.
abstract: The older of a pair of sisters experienced hypoglycemia after the start of thiamazole (MMI) treatment. Based on a high insulin antibody level, she was diagnosed with insulin autoimmune syndrome (IAS). HLA-DNA typing identified DRB1*04:06. Although a 75-g oral glucose tolerance test (OGTT) showed biphasic insulin secretion, the secretion pattern became monophasic after discontinuation of the MMI. The younger sister was diagnosed with IAS after the start of MMI treatment. HLA-DNA typing identified DRB1*04:06. The 75-g OGTT showed biphasic insulin secretion, but it became monophasic after discontinuation of the MMI. According to the similar insulin secretion kinetics in the two sisters with IAS, we suspect that a genetic predisposition may be associated with the features of anti-insulin antibodies.
authors.affiliation: First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Torimoto
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Okada
authors.forename: Hiroko
authors.initials: H
authors.lastname: Mori
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000235:genetics / Q000276:immunology; D005260:Female; D020022:Genetic Predisposition to Disease; D005951:Glucose Tolerance Test; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D006946:Hyperinsulinism / Q000139:chemically induced / Q000235:genetics / Q000276:immunology; D007003:Hypoglycemia / Q000139:chemically induced; D007328:Insulin / Q000378:metabolism; D007330:Insulin Antibodies / Q000097:blood*; D000078790:Insulin Secretion; D008713:Methimazole / Q000009:adverse effects* / Q000627:therapeutic use; D035781:Siblings
chemical_list: D013956:Antithyroid Agents; D059811:HLA-DRB1 Chains; D007328:Insulin; D007330:Insulin Antibodies; D008713:Methimazole