J Korean Diabetes.  2012 Jun;13(2):105-109. 10.4093/jkd.2012.13.2.105.

Insulin Autoimmune Syndrome with Diabetic Ketoacidosis

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea. yeojoo@schmc.ac.kr

Abstract

Insulin autoimmune syndrome is characterized by spontaneous hypoglycemia, elevated insulin level and a high level of insulin autoantibodies without previous insulin exposure. Among the clinical manifestations of insulin autoimmune syndrome, diabetic ketoacidosis is extremely rare. A 72-year-old diabetic woman was hospitalized with diabetic ketoacidosis. She suffered repeated fasting hypoglycemia after treatment of the diabetic ketoacidosis. Here we describe this case of insulin autoimmune syndrome manifested as diabetic ketoacidosis followed by recurrent hypoglycemia with a review of the relevant literature.

Keyword

Diabetic ketoacidosis; Hypoglycemia; Insulin autoantibody

MeSH Terms

Aged
Autoantibodies
Diabetic Ketoacidosis
Female
Humans
Hypoglycemia
Insulin
Autoantibodies
Insulin

Figure

  • Fig. 1 This figure shows that hypoglycemia was occurred at 360 min of 75 g oral glucose tolerance test.

  • Fig. 2 Abdominal computed tomography scan shows no evidence of any pancreatic mass.


Reference

1. Hirata Y, Ishizu H, Ouchi N, Motomura S, Abe M, Hara Y, Wakasugi H, Takahashi I, Takano H, Tanaka M, Kawano H, Kanesaki T. Insulin autoimmunity in a case of spontaneous hypoglycemia. J Jpn Diabetes Soc. 1970. 13:312–320.
2. Shim MS, Kim MY, Kim MJ, Lee Y, Lee BJ, Chung CH, Shin YG. A case of autoimmune hypoglycemia complicated with diabetic ketoacidosis. Yonsei Med J. 2004. 45:140–144.
Article
3. Chung JO, Cho DH, Chung DJ, Chung MY. Spontaneous Hypoglycemia due to Insulin Antibody after Insulin Treatment of Diabetic Ketoacidosis. Endocrinol Metab. 2010. 25:217–220.
Article
4. Lupsa BC, Chong AY, Cochran EK, Soos MA, Semple RK, Gorden P. Autoimmune forms of hypoglycemia. Medicine (Baltimore). 2009. 88:141–153.
Article
5. Uchigata Y, Hirata Y, Iwamoto Y. Insulin autoimmune syndrome (Hirata disease): epidemiology in Asia, including Japan. Diabetol Int. 2010. 1:21–25.
Article
6. Dons RF, Havlik R, Taylor SI, Baird KL, Chernick SS, Gorden P. Cl inical disorders associated wi t h autoantibodies to the insulin receptor. Simulation by passive transfer of immunoglobulins to rats. J Clin Invest. 1983. 72:1072–1080.
Article
7. Zick Y, Rees-Jones RW, Taylor SI, Gorden P, Roth J. The role of antireceptor antibodies in stimulating phosphorylation of the insulin receptor. J Biol Chem. 1984. 259:4396–4400.
Article
8. Bortolotti D, Mothe-Satney I, Ferrari P, Gautier N, Sonke J, Palle S, Bernard G, Badetti JL, Fredenrich A, Van Obberghen E, Canivet B. Spontaneous hypoglycaemia in the presence of both anti-insulin antibody and anti-insulin receptor antibody. Diabetes Metab. 2006. 32:598–603.
Article
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr