Endocrinology and Metabolism  2011;26(4):360-363

doi:10.3803/EnM.2011.26.4.360

A Case of the Type B Insulin Resistance Syndrome with Chronic Hepatitis B.

Hyun Seok CHOI 1 ; Byoung Ho CHOI ; Seok Hoo JEONG ; Shung Han CHOI ; Dong Su SHIN ; Sei hyun KIM ; Young Sil EOM ; Sihoon LEE ; Yeun Sun KIM ; Ie Byung PARK ; Ki Young LEE

Affiliations

+expand

Keywords

Insulin receptor antibody; Plasmapheresis; Type B insulin resistance syndrome

Country

Republic of Korea

Language

Korean

Abstract

Type B insulin resistance syndrome is rare autoimmune disease that is characterized by various abnormalities of glycemic homeostasis, from hyperglycemia caused by extreme insulin resistance to fasting hypoglycemia. It can combine with other autoimmune diseases, most commonly systemic lupus erythematosus. It usually occurs in women and accompanies acanthosis nigricans, hyperandrogenism, and, in many cases, ovary dysfunction. The diagnosis of type B insulin resistance syndrome is based largely on the presence of insulin receptor autoantibodies and hyperglycemia, or hypoglycemia and hyperinsulinemia. In some cases, patients with the type B insulin resistance have been successfully treated with immunosuppressive therapy and plasmapheresis. We experienced type B insulin resistance syndrome in a patient with chronic hepatitis B and used only plasmapheresis for treatment. The immunosuppressive therapy was omitted due to the state of activation of chronic hepatitis B. We present this case with a review of relevant literature.