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Autoimmune hypoglycemia

https://doi.org/10.14341/omet9536

Abstract

Autoimmune hypoglycemia is a condition caused by the interaction of endogenous antibodies to insulin or the insulin receptor. Awareness of autoimmune hypoglycemia is important, since the syndrome can cause severe neuroglycopenic symptoms, and should be considered in differential diagnosis of hypoglycemic syndromes. Timely establishment of the correct diagnosis will help to avoid unnecessary surgical interventions in patients who can be successfully treated with conservative support.

About the Authors

Marina Y. Yukina

Endocrinology Research Centre


Russian Federation

MD, PhD



Diana A. Davtyan

Endocrinology Research Centre


Russian Federation

MD



Ekaterina A. Troshina

Endocrinology Research Centre


Russian Federation

MD, PhD, Professor



Nurana F. Nuralieva

Endocrinology Research Centre


Russian Federation

MD



References

1. Hirata Y, Ishizu H. Elevated Insulin-binding Capacity of Serum Proteins in a Case with Spontaneous Hypoglycemia and Mild Diabetes Not Treated with Insulin. The Tohoku Journal of Experimental Medicine. 1972;107(3):277-286. doi: 10.1620/tjem.107.277.

2. Zhang Y, Zhao T. Hypoglycemic coma due to insulin autoimmune syndrome induced by methimazole: A rare case report. Exp. Ther. Med. 2014;8(5):1581-1584. doi: 10.3892/etm.2014.1964.

3. Uchigata Y, Hirata Y. Insulin Autoiimmune Syndrome (Hirata Disease). In: Eisenbarth, editor. Immunoendocrinology: Scientific and Clinical Aspects. Humana Press; 2011. pp. 343-368. doi: 10.1007/978-1-60327-478-4_21.

4. Ismail AAA. The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis. Clinical Chemistry and Laboratory Medicine (CCLM). 2016;54(11). doi: 10.1515/cclm-2015-1255.

5. Uchigata Y, Eguchi Y, Takayama-Hasumi S, et al. Strong association of insulin autoimmune syndrome with HLA-DR4. The Lancet. 1992;339(8790):393-394. doi: 10.1016/0140-6736(92)90080-m.

6. Ismail AAA. The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis. Clinical Chemistry and Laboratory Medicine (CCLM). 2016;54(11). doi: 10.1515/cclm-2015-1255.

7. Uchigata Y, Hirata Y, Iwamoto Y. Drug-induced insulin autoimmune syndrome. Diabetes Res. Clin. Pract. 2009;83(1):e19-e20. doi: 10.1016/j.diabres.2008.10.015.

8. Bodansky HJ, Dean BM, Bottazzo GF, et al. Islet-Cell Antibodies and Insulin Autoantibodies in Association with Common Viral Infections. The Lancet. 1986;328(8520):1351-1353. doi: 10.1016/s0140-6736(86)92003-9.

9. Ruiz-Giardin JM, Cremades C, Romero J, Marazuela M. Insulin autoimmune syndrome in a patient with viral hepatitis C. Clin. Endocrinol. (Oxf.). 2002;57(3):411-412. doi: 10.1046/j.1365-2265.2002.01604.x.

10. Li JK, Lee WK, Chan CH, et al. Auto-insulin antibodies due to methimazole in a patient with Myasthenia Gravis and Graves disease. Ann Gerontol Geriatric Res. 2015;2:1021–2.

11. Rouabhia S, Ramanoelina J, Godmer P, et al. [Insulin autoimmune syndrome revealing systemic lupus erythematosus]. Ann. Med. Interne (Paris). 2003;154(1):59-60.

12. Waldron-Lynch F, Inzucchi SE, Menard L, et al. Relapsing and Remitting Severe Hypoglycemia due to a Monoclonal Anti-insulin Antibody Heralding a Case of Multiple Myeloma. J. Clin. Endocr. Metab. 2012;97(12):4317-4323. doi: 10.1210/jc.2012-2388.

13. Halsall DJ, Mangi M, Soos M, et al. Hypoglycemia due to an Insulin Binding Antibody in a Patient with an IgA-κ Myeloma. J. Clin. Endocr. Metab. 2007;92(6):2013-2016. doi: 10.1210/jc.2007-0075.

14. Wong SL, Priestman A, Holmes DT. Recurrent Hypoglycemia from Insulin Autoimmune Syndrome. J. Gen. Intern. Med. 2013;29(1):250-254. doi: 10.1007/s11606-013-2588-9.

15. Masjhur JS. Insulin Autoimmune Syndrome (Hirata's disease): severe hypoglycemic episodes in Graves' hyperthyroidism patient treated with methimazole. Acta Med. Indones. 2005;37(4):214-217.

16. Orphanet: the portal for rare diseases and orphan drugs [Internet]. Available from: http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=2298

17. Arioglu E, Andewelt A, Diabo C, et al. Clinical Course of the Syndrome of Autoantibodies to the Insulin Receptor (Type B Insulin Resistance). Medicine. 2002;81(2):87-100. doi: 10.1097/00005792-200203000-00001.

18. Chon S, Choi MC, Lee YJ, et al. Autoimmune Hypoglycemia in a Patient with Characterization of Insulin Receptor Autoantibodies. Diabetes Metab. J. 2011;35(1):80. doi: 10.4093/dmj.2011.35.1.80.

19. Lupsa BC, Chong AY, Cochran EK, et al. Autoimmune Forms of Hypoglycemia. Medicine. 2009;88(3):141-153. doi: 10.1097/MD.0b013e3181a5b42e.

20. Malek R, Chong AY, Lupsa BC, et al. Treatment of Type B Insulin Resistance: A Novel Approach to Reduce Insulin Receptor Autoantibodies. J. Clin. Endocr. Metab. 2010;95(8):3641-3647. doi: 10.1210/jc.2010-0167.

21. Arzamendi AE, Rajamani U, Jialal I. Pseudoinsulinoma in a White Man With Autoimmune Hypoglycemia Due to Anti-Insulin Antibodies. Am. J. Clin. Pathol. 2014;142(5):689-693. doi: 10.1309/ajcpx56jqbjhubgj.

22. Narla RR, Hashimoto T, Kelly K, Heaney A. Hypoglycemia: A tale of three causes. Journal of Clinical and Translational Endocrinology: Case Reports. 2016;2:4-6. doi: 10.1016/j.jecr.2016.04.001.

23. Desimone ME, Weinstock RS. Non-Diabetic Hypoglycemia. [Updated 2016 Mar 25]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. 2000–2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK355894/

24. McAuley G, Delaney H, Colville J, et al. Multimodality preoperative imaging of pancreatic insulinomas. Clin. Radiol. 2005;60(10):1039-1050. doi: 10.1016/j.crad.2005.06.005.

25. Gama R. Best Practice No 173: Clinical and laboratory investigation of adult spontaneous hypoglycaemia. J. Clin. Pathol. 2003;56(9):641-646. doi: 10.1136/jcp.56.9.641.

26. Agin A, Charrie A, Chikh K, et al. Fast test: Clinical practice and interpretation. Ann. Endocrinol. (Paris). 2013;74(3):174-184. doi: 10.1016/j.ando.2013.05.003.


Supplementary files

1. Fig. 1. Localization of HLA genes in the 6th chromosome.
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Type Исследовательские инструменты
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For citations:


Yukina M.Y., Davtyan D.A., Troshina E.A., Nuralieva N.F. Autoimmune hypoglycemia. Obesity and metabolism. 2018;15(3):9-13. (In Russ.) https://doi.org/10.14341/omet9536

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