Severe autoimmune hypoglycemia with insulin antibodies necessitating plasmapheresis.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Subhashini YaturuAubrey Lurie

Abstract

To report a case of autoimmune hypoglycemia. We describe the clinical course of a patient with autoimmune hypoglycemia, including results of biochemical and histocompatibility antigen studies, as well as the therapeutic intervention and follow-up. A 77-year-old man presented with clinical manifestations of severe spontaneous hypoglycemia associated with extremely high levels of insulin (>300 mU/mL) and insulin antibodies (>100 U/mL) without any exogenous insulin administration. He had no other associated autoimmune disorder or exposure to the sulfhydryl group of drugs. Corticosteroid therapy was initiated, but the patient continued to have hypoglycemia and required plasmapheresis. The hypoglycemia resolved after plasmapheresis. During follow-up, the patient was treated with prednisone, the dose of which was tapered gradually. The insulin antibodies, which had decreased rapidly after plasmapheresis, gradually disappeared within a few months. The patient remained free of hypoglycemia as well as insulin antibodies 11 months after corticosteroid therapy was discontinued. Although autoimmune hypoglycemia is an uncommon disorder, it should be considered in any patient with hypoglycemia in the setting of nonsuppressed insulin levels a...Continue Reading

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Citations

May 15, 2009·Medicine·Beatrice C LupsaPhillip Gorden
Aug 28, 2013·Journal of General Internal Medicine·Sophia L WongDaniel T Holmes
Sep 15, 2016·Journal of Endocrinological Investigation·M V DaviUNKNOWN NIKE Group
Jan 8, 2014·Endocrinology and Metabolism·Eun RohSoo Heon Kwak
Mar 18, 2020·The Journal of Clinical Endocrinology and Metabolism·Genevieve L CalderRichard J MacIsaac
May 20, 2005·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Ananda BasuGeorge Eisenbarth
Oct 8, 2014·Experimental and Therapeutic Medicine·Yiyi Zhang, Tieyun Zhao
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Apr 21, 2020·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Daniele CappellaniPiero Marchetti

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