A case of autoimmune insulin syndrome |
Dong Jin Kim, Nan Hee Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi |
고려대학교 의과대학 내과학교실 |
증례:인슐린 자가면역성 증후군 1예 |
김동진, Nan Hee Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi |
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Abstract |
Autoimmune insulin syndrome is characterized by a combination of fasting hypoglycemia,
high total serum insulin concentrations, and the presence of autoantibodies to the native human
insulin in serum. A healthy 69-year-old man developed spontaneous hypoglycemia after being
given some medications for the common cold. His laboratory finding shows endogenous
hyperinsulinism. Therefore, an insulinoma was suspected but the imaging study shows no mass
lesion in the pancreas and the anti-insulin antibody titer was high(>100U/mL). He had no
specific medication history except for a treatment of a current upper respiratory infection (URI).
Among the URI medication, it was found that N-acetylcysteine contains a sulfhydryl group and
could induce autoimmunization. The patient was treated with corticosteroid for 3 months. His
anti-insulin antibody titer had decreased to normal level and has not shown any hypoglycemic
episodes for more than one and a half years. We present this case with a review of relevant
literature.(Korean J Med 71:683-687, 2006)
Key Words : Fasting hypoglycemia, Insulin antibodies, Acetylcysteine, Hyperinsulinism |
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