Endocrinology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, MAHE, Manipal, Karnataka, India.
Endocrinology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, MAHE, Manipal, Karnataka, India
BMJ Case Rep. 2020 Dec 9;13(12):e234448. doi: 10.1136/bcr-2020-234448.
Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycaemia, characterised by recurrent hypoglycaemic episodes secondary to insulin autoantibodies in individuals who are not exposed to exogenous insulin. We are reporting a case of IAS in a 64-year-old gentleman, who presented with predominant postprandial hypoglycaemic episodes. On biochemical evaluation, he was found to have hyperinsulinemic hypoglycaemia. Localisation studies with MRI abdomen and endoscopic ultrasound (EUS) were negative for pancreatic tumour. Tests sent for insulin antibody levels were elevated. The patient was treated with frequent meals, acarbose and glucocorticoids. Patient condition improved and did not experience hypoglycaemia on follow-up.
胰岛素自身免疫综合征（IAS）是低血糖症的罕见病因，其特征是在未接触外源性胰岛素的个体中，由于胰岛素自身抗体而反复发生低血糖发作。我们报告了一例 64 岁男性的 IAS 病例，该患者主要表现为餐后低血糖发作。生化评估发现他患有高胰岛素血症性低血糖症。腹部 MRI 和内镜超声（EUS）定位研究均未发现胰腺肿瘤。胰岛素抗体水平检测结果升高。患者接受了频繁进餐、阿卡波糖和糖皮质激素治疗。患者病情改善，随访中未发生低血糖。
