Insulin autoimmune syndrome: case report

Sao Paulo Medical Journal

Rodrigo Oliveira Moreira¹  Giovanna Aparecida Balarini Lima¹  Patrícia Carla Batista Peixoto¹  Maria Lucia Fleiuss Farias¹  Mario Vaisman¹ 

[1] ,Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho Endocrinology ServiceRio de Janeiro,Brazil

关键词: Hypoglycemia;    Hyperinsulinism;    Insulin;    Pancreatectomy;    Insulin antibodies;    Hipoglicemia;    Hiperinsulinismo;    Insulina;    Pancreatectomia;    Anticorpos antiinsulina;   

DOI  :  10.1590/S1516-31802004000400010

来源: SciELO

【 摘 要 】

CONTEXT: Insulin autoimmune syndrome (IAS, Hirata disease) is a rare cause of hypoglycemia in Western countries. It is characterized by hypoglycemic episodes, elevated insulin levels, and positive insulin antibodies. Our objective is to report a case of IAS identified in South America. CASE REPORT: A 56-year-old Caucasian male patient started presenting neuroglycopenic symptoms during hospitalization due to severe trauma. Biochemical evaluation confirmed hypoglycemia and abnormally high levels of insulin. Conventional imaging examinations were negative for pancreatic tumor. Insulin antibodies were above the normal range. Clinical remission of the episodes was not achieved with verapamil and steroids. Thus, a subtotal pancreatectomy was performed due to the lack of response to conservative treatment and because immunosuppressants were contraindicated due to bacteremia. Histopathological examination revealed diffuse hypertrophy of beta cells. The patient continues to have high insulin levels but is almost free of hypoglycemic episodes.

【 授权许可】

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