A case of autoimmune insulin syndrome.
- Author:
Dong Jin KIM
1
;
Nan Hee KIM
;
Ji A SEO
;
Sin Gon KIM
;
Kyung Mook CHOI
;
Sei Hyun BAIK
;
Dong Seop CHOI
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea. nhkim@kumc.or.kr
- Publication Type:Case Report
- Keywords:
Fasting hypoglycemia;
Insulin antibodies;
Acetylcysteine;
Hyperinsulinism
- MeSH:
Acetylcysteine;
Aged;
Autoantibodies;
Common Cold;
Humans;
Hyperinsulinism;
Hypoglycemia;
Insulin Antibodies;
Insulin*;
Insulinoma;
Pancreas
- From:Korean Journal of Medicine
2006;71(6):683-687
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Autoimmune insulin syndrome is characterized by a combination of fasting hypoglycemia, high total serum insulin concentrations, and the presence of autoantibodies to the native human insulin in serum. A healthy 69-year-old man developed spontaneous hypoglycemia after being given some medications for the common cold. His laboratory finding shows endogenous hyperinsulinism. Therefore, an insulinoma was suspected but the imaging study shows no mass lesion in the pancreas and the anti-insulin antibody titer was high(>100U/mL). He had no specific medication history except for a treatment of a current upper respiratory infection (URI). Among the URI medication, it was found that N-acetylcysteine contains a sulfhydryl group and could induce autoimmunization. The patient was treated with corticosteroid for 3 months. His anti-insulin antibody titer had decreased to normal level and has not shown any hypoglycemic episodes for more than one and a half years. We present this case with a review of relevant literature.
