Schlemper R J, Uchigata Y, Frölich M, Vingerhoeds A C, Meinders A E
Department of Internal Medicine and Endocrinology, University Hospital Leiden, Netherlands.
Neth J Med. 1996 May;48(5):188-92. doi: 10.1016/0300-2977(95)00085-2.
The insulin autoimmune syndrome is extremely rare outside of Japan. We describe a 45-year-old Caucasian woman who presented with fasting hypoglycaemia and weight gain. The presence of fasting insulin concentrations in excess of 1000 mU/l, very low C-peptide concentrations during hypoglycaemic attacks and high titres of insulin autoantibodies led to the diagnosis. Treatments aimed at decreasing endogenous insulin secretion by either dietary intervention alone or in combination with acarbose, octreotide or diazoxide had only limited success, while a 2-week course of immunosuppression with prednisone was without any antihypoglycaemic effect.
胰岛素自身免疫综合征在日本以外极为罕见。我们报告了一名45岁的白种女性，她出现空腹低血糖和体重增加。空腹胰岛素浓度超过1000 mU/l、低血糖发作时C肽浓度极低以及高滴度胰岛素自身抗体的存在导致了该诊断。单独通过饮食干预或联合使用阿卡波糖、奥曲肽或二氮嗪来减少内源性胰岛素分泌的治疗仅取得了有限的成功，而使用泼尼松进行为期2周的免疫抑制治疗没有任何抗低血糖作用。
