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Case Reports
. 2019 Feb 7:12:29-32.
doi: 10.2147/IMCRJ.S190908. eCollection 2019.

Insulin autoimmune syndrome as a cause of recurrent hypoglycemia in a carbimazole user: a case report from Nepal

Vivek Pant  1 , Bijay Bhandari  2 , Suman Baral  3 , Sangha Ratna Bajracharya  2
Affiliations
Case Reports

Insulin autoimmune syndrome as a cause of recurrent hypoglycemia in a carbimazole user: a case report from Nepal

Vivek Pant et al. Int Med Case Rep J. .

Abstract

Insulin autoimmune syndrome (IAS) is a rare cause of nondiabetic hypoglycemia characterized by hyperinsulinemia and autoantibodies to endogenous insulin without prior exposure to exogenous insulin. We report a drug-induced case of IAS in a 59-year-old Nepalese female. She had been taking carbimazole for Graves' disease and later presented with recurrent episodes of hypoglycemia, with laboratory findings of low blood glucose, increased molar ratio of insulin to C-peptide, and elevated autoantibodies to insulin. IAS should be considered while evaluating hypoglycemia to prevent unwarranted invasive procedures and surgical interventions.

Keywords: Hirata disease; carbimazole; hypoglycemia; insulin autoimmune syndrome.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Plot showing serum level of anti-insulin antibody before and after treatment.
See this image and copyright information in PMC

References

    1. Hirata Y. Insulin autoimmunity in a case of spontaneous hypoglycemia. J Jpn Diabet Soc. 1970;13:312–319.
    1. Uchigata Y. Insulin autoimmune syndrome (IAS, Hirata disease) Ann Med Interne (Paris) 1999;150:245–253. - PubMed
    1. Redmon JB, Nuttall FQ. Autoimmune hypoglycemia. Endocrinol Metab Clin North Am. 1999;28(3):603–618. - PubMed
    1. Yamada T, Imai J, Ishigaki Y, Hinokio Y, Oka Y, Katagiri H. Possible relevance of HLA-DRB1*0403 haplotype in insulin autoimmune syndrome induced by alpha-lipoic acid, used as a dietary supplement. Diabetes Care. 2007;30(12):e131–e131. - PubMed
    1. Uchigata Y, Hirata Y, Iwamoto Y. Drug-induced insulin autoimmune syndrome. Diabetes Res Clin Pract. 2009;83(1):e19–e20. - PubMed

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