Kawashiri Shin-Ya, Kawakami Atsushi, Fujikawa Keita, Iwamoto Naoki, Aramaki Toshiyuki, Tamai Mami, Nakamura Hideki, Origuchi Tomoki, Ida Hiroaki, Eguchi Katsumi
Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University.
Intern Med. 2010;49(5):487-90. doi: 10.2169/internalmedicine.49.2746. Epub 2010 Mar 1.
Type B insulin resistance is characterized by the appearance of autoantibodies to the insulin receptor. We present a 59-year-old Japanese man with type B insulin resistance complicated with systemic lupus erythematosus (SLE). A high titer of anti-insulin receptor autoantibodies was revealed when SLE was defined as active disease. Intravenous boluses of cyclophosphamide (IVCY) with oral prednisolone and cyclosporin A induced remission of SLE, and a subsequent disappearance of anti-insulin receptor autoantibodies, followed by a recovery of glucose intolerance. This is a rare and important case report showing a clear correlation between anti-insulin receptor autoantibodies of type B insulin resistance and SLE disease activity.
B型胰岛素抵抗的特征是出现胰岛素受体自身抗体。我们报告一例59岁的日本男性，患有B型胰岛素抵抗并合并系统性红斑狼疮（SLE）。当SLE被定义为活动性疾病时，发现了高滴度的抗胰岛素受体自身抗体。静脉注射环磷酰胺（IVCY）联合口服泼尼松龙和环孢素A诱导SLE缓解，随后抗胰岛素受体自身抗体消失，接着糖耐量异常恢复。这是一例罕见且重要的病例报告，显示了B型胰岛素抵抗的抗胰岛素受体自身抗体与SLE疾病活动之间存在明确的相关性。
