Histological Study of the Pancreatic Islets in Insulin Autoimmune Syndrome: A Case Report.
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An 80-year-old woman was admitted because of ileus and liver cirrhosis. She suffered from spontaneous hypoglycemia in the absence of insulin injections. A diagnosis of Insulin Autoimmune Syndrome was made, because high titers of insulin antibody were detected in her serum. The patients was treated with prednisolone, her insulin antibody levels fell, and no hypoglycemia occurred. She suffered hypoglycemia frequently, however, after the dose of prednisolone was reduced. We discussed steroid pulse therapy or immunosuppressive therapy, but did not institute it because of her poor gereral conditions, and the patient died of pneumonia. At autopsy, grossly the pancreas was slightly atrophic and a pseudocyst about 1 cm in diameter had formed in the tail. Microscopic examination of the pancreas revealed slight exocrine cell degeneration with mild intra-and interlobular fibrosis. The islets varied in size, and some of them are crowded out by connective tissue around the cyst wall. Immunohistochemically, the islets showed a normal distribution of insulin-, glucagon-, and somatostatin-producing cells, and some ductal epithelial cells seemed to be producing the insulin.
- 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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