Insulin autoimmune syndrome caused by omeprazole
10.3760/cma.j.cn114015-20231018-00740
- VernacularTitle:奥美拉唑致胰岛素自身免疫综合征
- Author:
Yan TANG
1
;
Juan ZHANG
;
Shujie ZHANG
;
Yan JIANG
;
Xiang ZHOU
Author Information
1. 中国医学科学院北京协和医学院/北京协和医院药剂科，北京 100730
- Publication Type:Journal Article
- Keywords:
Hypoglycemia;
Proton pump inhibitors;
Omeprazole;
Insulin autoimmune syndrome;
Susceptibility genes
- From:
Adverse Drug Reactions Journal
2024;26(8):506-509
- CountryChina
- Language:Chinese
-
Abstract:
A 74-year-old female had multiple episodes of dizziness, palpitations, and sweating, among the 2 episodes, her venous blood glucose levels were 2.4 mmol/L and 2.5 mmol/L, C-peptide levels were 6.79 mg/L and 6.24 μg/L, insulin >1 500 mU/L, and synchronous proinsulin levels were 2 896 ng/L and 2 989 ng/L. The patient's urinary ketone bodies was negative, and insulin autoantibodies (IAA) was >400 RU/ml. These indicators were accorded with insulin mediated hypoglycemia. The patient had a history of taking omeprazole intermittently, had no history of diabetes, and refuted the history of using exogenous insulin, sulfonylureas and sulfhydryl drugs. Based on physical examination and relevant examinations, combined with the patient′s human leukocyte antigen (HLA) classification (HLA-DRB1 04∶03) and medication history, it was considered that the patient was more likely to have omeprazole-induced insulin autoimmune syndrome. Omeprazole was stopped. After adjusting the dietary structure and adding acarbose treatment for 3 months, the patient′s IAA level decreased to 36 RU/ml, and the fasting insulin decreased to 131.7 mU/L; after 9 months, the patient′s IAA turned negative and their fasting insulin decreased to 23.3 mU/L, with no further episodes of hypoglycemia.
