A case of insulin autoimmune syndrome successfully treated with methylprednisolone pulse therapy.
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A 40-year-old woman taking an antithyroid drug for Graves' disease was overcome by somnolence resulting from hypoglycemia (plasma glucose 34 mg/d<I>l</I>). Although she had never received insulin injections, antibodies against insulin were found in her serum, and a large amount of immunoreactive insulin was extracted. The immunoglobulin class of the antibodies was IgG and light chains were predominantly of the kappa type. The percent <SUP>125</SUP>I-insulin binding in her serum was high, and was diminished by the addition of cold human insulin. HLA haplotype of the patient was HLA-A 24, A 11, B 7, Bw 60, Cw 3, Cw 7. She was diagnosed as having insulin autoimmune syndrome and was treated with high dose methylprednisolone which relieved her of the hypoglycemia, and subtotal thyroidectomy was subsequently performed. Six months after the episode of hypoglycemia, the patient was in a euthyroid state and had no hypoglycemic attacks in spite of the presence of autoantibodies against insulin in her serum. Methimazole seemed to trigger the production of autoantibodies against insulin in this patient and methylprednisolone pulse therapy was effective.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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