Insulin autoimmune syndrome

Area of Science:

• Endocrinology
• Immunology
• Genetics

Background:

• Insulin autoimmune syndrome (Hirata's disease) is an autoimmune disorder characterized by autoantibodies to insulin, leading to recurrent hypoglycemia.
• Physicians often overlook this condition in differential diagnoses of hypoglycemia due to perceived rarity, resulting in suboptimal patient management.
• The syndrome is linked to specific Human Leukocyte Antigen (HLA) alleles and often triggered by drugs containing sulfhydryl groups in predisposed individuals.

Purpose of the Study:

• To highlight the clinical presentation and diagnostic challenges of insulin autoimmune syndrome.
• To emphasize the importance of considering this condition in the differential diagnosis of hypoglycemia.
• To report the first case of insulin autoimmune syndrome in an adult in Russia.

Main Methods:

• Literature review on insulin autoimmune syndrome.
• Case report of an adult patient diagnosed with insulin autoimmune syndrome.
• Analysis of clinical presentation, diagnostic findings, and treatment outcomes.

Main Results:

• Insulin autoimmune syndrome presents with hypoglycemic episodes due to anti-insulin antibodies.
• Association with specific HLA alleles and sulfhydryl-containing drugs is noted.
• Delayed diagnosis can lead to unnecessary treatments, including surgery.

Conclusions:

• Insulin autoimmune syndrome is an underdiagnosed cause of hypoglycemia that requires specific diagnostic consideration.
• Early and accurate diagnosis facilitates conservative management, avoiding invasive procedures.
• This report contributes to the understanding of insulin autoimmune syndrome in diverse populations.