[Insulin autoimmune syndrome : A rare, but important differential diagnosis of hypoglycemia].

4区 医学 Q3 Medicine
Internist Pub Date : 2022-02-01 Epub Date: 2021-10-26 DOI:10.1007/s00108-021-01180-0
Tiago de Castro, Christoph Beier, Christoph Terkamp, Lucia Oehler, Bernhard M W Schmidt, Johannes Heck, Dirk Stichtenoth, Heiner Wedemeyer, Holger Leitolf
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引用次数: 2

Abstract

A 69-year-old female patient was referred to the Medical University of Hanover for further diagnostic evaluation of recurrent severe hypoglycemia. The patient had previously been started on clopidogrel after arterial stenting for peripheral arterial obstructive disease (PAOD). The presence of an insulinoma and paraneoplastic syndrome was excluded. Increased serum insulin and insulin autoantibodies levels were confirmed, despite normal to low blood sugar levels. An insulin autoimmune syndrome was diagnosed, most likely induced by the prior intake of clopidogrel. Treatment with immunoadsorption was initiated, achieving a significant reduction in hypoglycemic events and a lasting response to treatment over 3 months.

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胰岛素自身免疫综合征:低血糖的一种罕见但重要的鉴别诊断。
一位69岁的女性患者被转介到汉诺威医科大学进一步诊断评估复发性严重低血糖。该患者曾在接受外周动脉阻塞性疾病(PAOD)动脉支架植入术后开始使用氯吡格雷。排除了胰岛素瘤和副肿瘤综合征的存在。血清胰岛素和胰岛素自身抗体水平升高,尽管血糖正常到低。诊断为胰岛素自身免疫综合征,很可能是由先前摄入氯吡格雷引起的。开始免疫吸附治疗,低血糖事件显著减少,治疗持续3个月以上。
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来源期刊
Internist
Internist 医学-医学:内科
CiteScore
1.20
自引率
0.00%
发文量
139
审稿时长
4-8 weeks
期刊介绍: Der Internist is an internationally respected journal dealing with all aspects of internal medicine. The journal serves both the scientific exchange and the continuing education of internists working in practical or clinical environments as well as of general practitioners who are particularly interested in internal medicine. The focus is on the topics of prevention, diagnostic approaches, management of complications, and current therapy strategies. Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice.
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