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Published on: March 23, 2018
Recurrent hypoglycemia from insulin autoimmune syndrome
Sophia L Wong1, Anne Priestman, Daniel T Holmes
1Division of Medical Biochemistry, Department of Pathology and Laboratory Medicine, University of British Columbia, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada, SWong6@providencehealth.bc.ca.
Journal of General Internal Medicine
|August 28, 2013
Summary
Insulin autoimmune syndrome (IAS) causes hypoglycemia due to insulin antibodies. This rare condition requires careful diagnosis to avoid unnecessary surgery for patients with recurrent hypoglycemia.
Area of Science:
- Endocrinology
- Immunology
Background:
- Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia.
- Characterized by autoantibodies to endogenous insulin in patients without prior exogenous insulin exposure.
- Increasingly recognized globally, it's the third leading cause of spontaneous hypoglycemia in Japan.
Observation:
- A case of IAS in a Caucasian woman presenting with recurrent hypoglycemia.
- Laboratory findings during a hypoglycemic event: low glucose, markedly elevated insulin and C-peptide, and high insulin to C-peptide ratio.
- Significantly elevated autoantibodies to insulin were detected.
Findings:
- The patient exhibited classic laboratory hallmarks of IAS during a spontaneous hypoglycemic episode.
- Diagnostic confirmation relied on detecting high levels of insulin autoantibodies.
Implications:
- IAS diagnosis is critical for non-diabetic individuals experiencing hypoglycemia.
- Differentiating IAS from insulinoma is crucial to prevent unnecessary invasive procedures and surgery.
- Highlights the importance of considering autoimmune conditions in unexplained hypoglycemia.
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