Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors
Background/Objective: Insulin autoimmune syndrome (IAS) is a very rare cause of hypoglycemia presenting with recurrent fasting or postprandial hypoglycemia episodes with elevated serum insulin levels and insulin autoantibodies. The objective of this case is to highlight the importance of considering...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | AACE Clinical Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2376060523000974 |
| _version_ | 1797686812065398784 |
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| author | Vikash Kumar, MD Dhir Gala, BS Ibnul Rafi, BS Mili Shah, BS Sabrin Marowa, MD Diksha Kaul, MD Simon Lukose, MD Saka Kazeem, MD |
| author_facet | Vikash Kumar, MD Dhir Gala, BS Ibnul Rafi, BS Mili Shah, BS Sabrin Marowa, MD Diksha Kaul, MD Simon Lukose, MD Saka Kazeem, MD |
| author_sort | Vikash Kumar, MD |
| collection | DOAJ |
| description | Background/Objective: Insulin autoimmune syndrome (IAS) is a very rare cause of hypoglycemia presenting with recurrent fasting or postprandial hypoglycemia episodes with elevated serum insulin levels and insulin autoantibodies. The objective of this case is to highlight the importance of considering IAS in patients with hypoglycemia. Case Report: We present a case of an 81-year-old female who presented with symptoms of hypoglycemia. She was found to have hyperinsulinemic hypoglycemic episodes without any apparent risk factors for IAS. She had positive–insulin autoantibodies in her serum leading to the diagnosis of IAS. Acutely, hypoglycemia was managed with D50 pushes, oral glucose, and glucagon injection. Discussion: Patients who present with hypoglycemia due to endogenous hyperinsulinemia should have IAS considered as a possible differential diagnosis. Insulin autoantibodies are measured as the gold standard diagnostic test for IAS. Foods with a low glycemic index are the primary treatment for IAS. Conclusion: This case presentation highlights the importance of considering IAS as a differential diagnosis in patients presenting with hypoglycemia secondary to hyperinsulinemia, even in the absence of apparent risk factors. |
| first_indexed | 2024-03-12T01:10:11Z |
| format | Article |
| id | doaj.art-d16864558e494483890b8444c550629a |
| institution | Directory Open Access Journal |
| issn | 2376-0605 |
| language | English |
| last_indexed | 2024-03-12T01:10:11Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AACE Clinical Case Reports |
| spelling | doaj.art-d16864558e494483890b8444c550629a2023-09-14T04:54:15ZengElsevierAACE Clinical Case Reports2376-06052023-09-0195146148Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk FactorsVikash Kumar, MD0Dhir Gala, BS1Ibnul Rafi, BS2Mili Shah, BS3Sabrin Marowa, MD4Diksha Kaul, MD5Simon Lukose, MD6Saka Kazeem, MD7Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York; Address correspondence to Dr Vikash Kumar, Department of Internal Medicine, The Brooklyn Hospital Center, 121 DeKalb Ave, Brooklyn, NY 11201.American University of the Caribbean School of Medicine, Cupecoy, Sint MaartenAmerican University of the Caribbean School of Medicine, Cupecoy, Sint MaartenAmerican University of the Caribbean School of Medicine, Cupecoy, Sint MaartenDepartment of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New YorkDepartment of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New YorkDepartment of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New YorkDepartment of Endocrinology, The Brooklyn Hospital Center, Brooklyn, New YorkBackground/Objective: Insulin autoimmune syndrome (IAS) is a very rare cause of hypoglycemia presenting with recurrent fasting or postprandial hypoglycemia episodes with elevated serum insulin levels and insulin autoantibodies. The objective of this case is to highlight the importance of considering IAS in patients with hypoglycemia. Case Report: We present a case of an 81-year-old female who presented with symptoms of hypoglycemia. She was found to have hyperinsulinemic hypoglycemic episodes without any apparent risk factors for IAS. She had positive–insulin autoantibodies in her serum leading to the diagnosis of IAS. Acutely, hypoglycemia was managed with D50 pushes, oral glucose, and glucagon injection. Discussion: Patients who present with hypoglycemia due to endogenous hyperinsulinemia should have IAS considered as a possible differential diagnosis. Insulin autoantibodies are measured as the gold standard diagnostic test for IAS. Foods with a low glycemic index are the primary treatment for IAS. Conclusion: This case presentation highlights the importance of considering IAS as a differential diagnosis in patients presenting with hypoglycemia secondary to hyperinsulinemia, even in the absence of apparent risk factors.http://www.sciencedirect.com/science/article/pii/S2376060523000974insulin autoimmune syndromeHirata diseaserefractory hypoglycemiainsulin autoantibody |
| spellingShingle | Vikash Kumar, MD Dhir Gala, BS Ibnul Rafi, BS Mili Shah, BS Sabrin Marowa, MD Diksha Kaul, MD Simon Lukose, MD Saka Kazeem, MD Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors AACE Clinical Case Reports insulin autoimmune syndrome Hirata disease refractory hypoglycemia insulin autoantibody |
| title | Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors |
| title_full | Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors |
| title_fullStr | Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors |
| title_full_unstemmed | Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors |
| title_short | Autoimmune Hypoglycemia With Anti-Insulin Autoantibodies in an Eighty-One-Year-Old Woman Without Apparent Risk Factors |
| title_sort | autoimmune hypoglycemia with anti insulin autoantibodies in an eighty one year old woman without apparent risk factors |
| topic | insulin autoimmune syndrome Hirata disease refractory hypoglycemia insulin autoantibody |
| url | http://www.sciencedirect.com/science/article/pii/S2376060523000974 |
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