The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2009;76(1):122-126.
인슐린 자가면역 증후군 1예
조 현, 오쌍용, 김유정, 박찬성, 김은숙, 김영일, 남궁일성
A case of insulin autoimmune syndrome
Hyun Cho, Ssang Yong Oh, You Jung Kim, Chan Sung Bak, Eun Sook Kim, Young Il Kim, Il Seong Nam-Goong


Abstract
Insulin autoimmune syndrome is an uncommon cause of hypoglycemia. According to the type of antibody, it can be classified as caused by insulin or insulin receptor autoantibodies. Generally, insulin autoimmune syndrome develops following exposure to exogenous insulin or sulfhydryl medications, although insulin or insulin receptor antibody may also occur spontaneously. We treated a 54-year-old woman who developed spontaneous hypoglycemia. The patient had repeated hypoglycemia despite the infusion of dextrose solution. Her serum insulin, c-peptide, and insulin autoantibody were elevated, even during the hypoglycemic periods. Insulin receptor autoantibody and HLA-cw4/B62/DR4 were positive. After steroid and diazoxide treatment, the hypoglycemic symptoms improved gradually. No further hypoglycemic episodes occurred after tapering the medication over 1 year. We present a case of insulin autoimmune syndrome with positive insulin and insulin receptor autoantibodies. (Korean J Med 76:S122- S126, 2009)

Keywords :Hypoglycemia, Insulin autoimmune syndrome, Insulin autoantibody, Insulin receptor autoantibody
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