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Insulin Autoimmune Syndrome - An After-Meal Roller Coaster Ride
Chee Koon Low1, Hui Chin Wong1, Saraswathy Apparow2
1Endocrine Unit, Department of Medicine, Hospital Tengku Ampuan Rahimah, Klang, Malaysia.
Journal of the ASEAN Federation of Endocrine Societies
|June 12, 2024
Summary
Hypoglycemic disorders without diabetes are rare and difficult to diagnose. This case highlights insulin autoimmune syndrome caused by carbimazole in a patient with Graves
Area of Science:
- Endocrinology
- Internal Medicine
- Pharmacology
Background:
- Hypoglycemic disorders are uncommon in non-diabetic individuals.
- Identifying the cause of hypoglycemia can be clinically challenging.
- Graves' disease is an autoimmune disorder affecting the thyroid gland.
Observation:
- A middle-aged Chinese man with Graves' disease presented with hypoglycemia.
- The patient was being treated with carbimazole, a medication used for hyperthyroidism.
- Insulin autoimmune syndrome was suspected as the cause of hypoglycemia.
Findings:
- Carbimazole induced insulin autoimmune syndrome in this patient.
- The patient's hypoglycemia was successfully managed conservatively.
- Treatment involved dietary modifications and an alpha-glucosidase inhibitor.
Implications:
- This case underscores the importance of considering drug-induced autoimmune conditions in unexplained hypoglycemia.
- Carbimazole can precipitate insulin autoimmune syndrome, even in patients without diabetes.
- Conservative management strategies can be effective for this rare condition.
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