Insulin autoimmune syndrome

Author:

Yukina Marina1,Nuralieva Nurana1,Solovyev Maksim1,Troshina Ekaterina12,Vasilyev Evgeny3

Affiliation:

1. 1Department of Therapeutic Endocrinology, Endocrinology Research Centre (ERC), Moscow, Russia

2. 2Russian Academy of Sciences, Endocrinology Service, Department of Therapeutic Endocrinology, Endocrinology Research Centre (ERC), Moscow, Russia

3. 3Laboratory of Inherited Endocrine Disorders, Endocrinology Research Centre (ERC), Moscow, Russia

Abstract

Summary Insulin autoimmune syndrome (Hirata’s disease) is a disorder caused by development of autoantibodies to insulin and manifested by hypoglycaemic syndrome. The overwhelming majority of physicians do not include it in the differential diagnosis of hypoglycaemic states because of a misconception of an extremely low prevalence of this condition. This results in unnecessary drug therapy and unjustified surgical interventions in patients that otherwise would be successfully treated conservatively. This disease is strongly associated with certain alleles of the HLA gene. In most cases, this condition develops in predisposed individuals taking drugs containing sulfhydryl groups. Formation of autoantibodies to insulin may be observed in patients with other autoimmune disorders, as well as in those with multiple myeloma or monoclonal gammopathy of undetermined significance. This paper presents the first Russian case report of insulin autoimmune syndrome in an adult patient. Learning points: Insulin autoimmune syndrome, Hirata’s disease, anti-insulin antibodies, and hypoglycaemia.

Publisher

Bioscientifica

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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