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The Korean Journal of Medicine 2006;71(6): 683-687.
증례:인슐린 자가면역성 증후군 1예
김동진, Nan Hee Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi
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
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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