Lu C C, Lee J K, Lam H C, Yang C Y, Han T M
Department of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Nov;54(5):353-8.
Insulin autoimmune syndrome (IAS) includes fasting or reactive hypoglycemia, hyperinsulinemia and the presence of insulin-binding antibodies in patients who have never been exposed to exogenous insulin. The report concerns a 34-year-old male patient with Graves' disease who had history of having taken methimazole for two months, without any consequence, 4 years previously. However, when methimazole was again administered for three weeks followed by a week of carbimazole, the patient suffered hypoglycemia 4 times during the next 4 weeks. He denied history of diabetes mellitus (DM), of taking any oral hypoglycemic agent or of having received insulin injection. Laboratory data showed total serum insulin level > 320 microU/mL, free insulin 55 microU/mL and insulin antibody 88.3%. Oral glucose tolerance test (OGTT) revealed DM pattern. Since the patient had history of allergy to anti-thyroid drugs before this event, so he was treated with radioiodine (131I). There was no episode of hypoglycemic attack during 15 months of follow-up.
胰岛素自身免疫综合征（IAS）包括空腹或反应性低血糖、高胰岛素血症，以及从未接触过外源性胰岛素的患者体内存在胰岛素结合抗体。本文报告了一名34岁患有格雷夫斯病的男性患者，该患者4年前曾服用甲巯咪唑两个月，未出现任何不良反应。然而，当再次服用甲巯咪唑三周，随后服用卡比马唑一周后，患者在接下来的4周内出现了4次低血糖。他否认有糖尿病（DM）病史、服用过任何口服降糖药或接受过胰岛素注射。实验室数据显示血清总胰岛素水平>320微单位/毫升，游离胰岛素55微单位/毫升，胰岛素抗体88.3%。口服葡萄糖耐量试验（OGTT）显示为糖尿病模式。由于该患者在此事件发生前有抗甲状腺药物过敏史，因此接受了放射性碘（131I）治疗。在15个月的随访期间未发生低血糖发作。
