title: A systemic lupus erythematosus patient presenting as type B insulin resistance complicated with cryoglobulinemia.
abstract: Systemic lupus erythematosus (SLE) patients may present with various symptoms and multisystem damage. We reported a 63-year-old male patient with SLE presenting as type B insulin resistance (TBIR) complicated with cryoglobulinemia. TBIR is an extremely rare disease, which is a manifestation of anti-insulin receptor antibodies (AIRA). Clinical feature is a sudden onset of hyperglycemia with major weight loss; however, the ensuing refractory hypoglycemia is more fatal. The average dosage of exogenous insulin is 5100 U/d. SLE patients with AIRA had poor prognosis, most of whom died of SLE activity. Cryoglobulins are immunoglobulins that reversibly precipitate in the cold, which will induce clinical symptoms. Non-infectious mixed cryoglobulinemia is frequently secondary to autoimmune diseases, such as SLE. Our patient was prescribed methylprednisolone (MP) and cyclophosphamide (CTX). Finally he had remission during the short-term follow-up. To our knowledge, this is the first case report of an SLE patient presenting as TBIR complicated with cryoglobulinemia.
authors.affiliation: Department of Gastroenterology, Peking University People's Hospital, Beijing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Nephrology, Peking University People's Hospital, Beijing, China yanmail10004@163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Nephrology, Peking University People's Hospital, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Nephrology, Peking University People's Hospital, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Zuo
mesh_terms: D003449:Cryoglobulinemia / Q000175:diagnosis* / Q000209:etiology; D003520:Cyclophosphamide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction
chemical_list: D003520:Cyclophosphamide; D008775:Methylprednisolone
keywords: Systemic lupus erythematosus (SLE); cryoglobulinemia; type B insulin resistance (TBIR)