Late Postprandial Hypoglycemia due to Bioactive Insulin Dissociation from Autoantibody Leading to Unconsciousness in a Patient with Insulin Autoimmune Syndrome
スポンサーリンク
概要
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We report here the case of an 83-year-old man who was treated for unconsciousness and hypoglycemia (39 mg/dL) accompanied by marked elevation of serum immunoreactive insulin (IRI) (4,760 μIU/mL). We diagnosed his condition as insulin autoimmune syndrome (IAS, Hirata disease) because of a high insulin autoantibody (IAA) titer (>90%: bound/total) and no history of exogenous insulin administration. Reactive hypoglycemia occurred due to immediate association followed by dissociation between insulin and insulin autoantibodies after glucose or food intake. An α-glucosidase inhibitor in combination with frequent small meals reduced the postprandial hyperglycemia (glucose spike) and ameliorated the reactive hypoglycemia.
著者
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Suzuki Ryoko
Department Of Biomolecular Science Faculty Of Science Toho University
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Okamoto Yoshihisa
Department Of Bioregulation Nippon Medical School
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Kondo Michi
Department Of Internal Medicine Wakayama Rosai Hospital
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Kawashima Akira
Department of Medicine, Kidney Center, Tokyo Women's Medical University
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Okamoto Yoshihisa
Department of Bioregulation, Nippon Medical School, Japan
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Miyata Kaori
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Miyata Kaori
Department of Chemistry, Faculty of Science, Kyushu University
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Nasu Tetsushi
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Uno Akiko
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Nakao Ryutaro
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Nakao Taisei
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Nakao Taisei
Department of Internal Medicine, Naga Municipal Hospital
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Nakao Ryutaro
Department of Internal Medicine, Naga Municipal Hospital
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Nasu Tetsushi
Department of Internal Medicine, Naga Municipal Hospital
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Uno Akiko
Department of Internal Medicine, Naga Municipal Hospital
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Kondo Michi
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Suzuki Ryoko
Department of Internal Medicine, Naga Municipal Hospital, Japan
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Kawashima Akira
Department of Internal Medicine, Naga Municipal Hospital
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Kawashima Akira
Department of Internal Medicine, Naga Municipal Hospital, Japan
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