Korean J Med > Volume 76(5); 2009 > Article
The Korean Journal of Medicine 2009;76(5):600-604.
A case of insulin autoimmune syndrome related to alpha-lipoic acid
Hyoung Jin Chang, Hyun Sook Choi, Mi Youn Park, Sung Min Leem, Yi Sun Jang, Kang Seo Park, Jong Min Lee
Alpha lipoic acid와 연관된 인슐린자가면역증후군 1예
장형진, 최현숙, 박미연, 임성민, 장이선, 박강서, 이종민
Abstract
Insulin autoimmune syndrome is characterized by spontaneous hypoglycemia, high concentrations of serum immunoreactive insulin, and the presence of autoantibodies to insulin without previous insulin injection. A 71-year-old woman with diabetes, who had been treated with oral hypoglycemic agents, suffered from frequent hypoglycemia. High insulin levels and the presence of insulin autoantibodies were shown, so insulin autoimmune syndrome was diagnosed. Drugs containing sulfhydryl groups play an important role in the pathogenesis of insulin autoimmune syndrome. Alpha-lipoic acid, which contains a sulfhydryl group, was administered before the onset of hypoglycemia. The patient’s human leukocyte antigen (HLA) type was HLA-Cw4 and DRB1*0406. There is a strong correlation between HLA-DRB1*0406 and insulin autoimmune syndrome. The patient was treated with prednisolone and has not had a hypoglycemic attack since. We report a case of insulin autoimmune syndrome, possibly associated with alpha-lipoic acid.
Key Words: Insulin autoimmune syndrome; Alpha-lipoic acid; HLA-DRB1*0406


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