Complete laboratory diagnosis of Insulin Autoimmune Syndrome
The definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard or to confirm an analytical interference and d...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Practical Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352551723000148 |
| _version_ | 1827824923869970432 |
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| author | Raquel Galván Patricia Fernández-Riejos Pilar María Sánchez Martínez Carmen Rodríguez-Chacón Catalina Sánchez Mora Antonio León-Justel |
| author_facet | Raquel Galván Patricia Fernández-Riejos Pilar María Sánchez Martínez Carmen Rodríguez-Chacón Catalina Sánchez Mora Antonio León-Justel |
| author_sort | Raquel Galván |
| collection | DOAJ |
| description | The definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard or to confirm an analytical interference and diagnose a possible Insulin Autoimmune Syndrome we performed the following investigations: dilution linearity test, heterophilic antibody blocking, polyethylene glycol precipitation, measurements with alternative assays, and gel filtration chromatography by size exclusion. The latter technique confirmed that most of the insulin was complexed with a 150-kDa protein, corresponding to immunoglobulin G, identified as insulin autoantibodies. These antibodies were responsible for hypoglycemia attacks in the patient, who had a previous autoimmune disease. This case highlights the importance of carefully analyzing the results and ruling out possible interferences, as well as considering all kinds of pathologies, even if they are infrequent. |
| first_indexed | 2024-03-12T02:34:14Z |
| format | Article |
| id | doaj.art-dc1c5cad50f7430f99daa83d9e59a034 |
| institution | Directory Open Access Journal |
| issn | 2352-5517 |
| language | English |
| last_indexed | 2024-03-12T02:34:14Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Practical Laboratory Medicine |
| spelling | doaj.art-dc1c5cad50f7430f99daa83d9e59a0342023-09-05T04:15:57ZengElsevierPractical Laboratory Medicine2352-55172023-08-0136e00320Complete laboratory diagnosis of Insulin Autoimmune SyndromeRaquel Galván0Patricia Fernández-Riejos1Pilar María Sánchez Martínez2Carmen Rodríguez-Chacón3Catalina Sánchez Mora4Antonio León-Justel5Corresponding author.; Laboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainLaboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainLaboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainLaboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainLaboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainLaboratory Medicine Department, Virgen Macarena University Hospital, Av. Dr. Fedriani, 3, 41009, Seville, Andalusia, SpainThe definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard or to confirm an analytical interference and diagnose a possible Insulin Autoimmune Syndrome we performed the following investigations: dilution linearity test, heterophilic antibody blocking, polyethylene glycol precipitation, measurements with alternative assays, and gel filtration chromatography by size exclusion. The latter technique confirmed that most of the insulin was complexed with a 150-kDa protein, corresponding to immunoglobulin G, identified as insulin autoantibodies. These antibodies were responsible for hypoglycemia attacks in the patient, who had a previous autoimmune disease. This case highlights the importance of carefully analyzing the results and ruling out possible interferences, as well as considering all kinds of pathologies, even if they are infrequent.http://www.sciencedirect.com/science/article/pii/S2352551723000148InsulinC-peptideInsulin autoantibodyInterferenceInsulin autoimmune syndromeSize exclusion chromatography |
| spellingShingle | Raquel Galván Patricia Fernández-Riejos Pilar María Sánchez Martínez Carmen Rodríguez-Chacón Catalina Sánchez Mora Antonio León-Justel Complete laboratory diagnosis of Insulin Autoimmune Syndrome Practical Laboratory Medicine Insulin C-peptide Insulin autoantibody Interference Insulin autoimmune syndrome Size exclusion chromatography |
| title | Complete laboratory diagnosis of Insulin Autoimmune Syndrome |
| title_full | Complete laboratory diagnosis of Insulin Autoimmune Syndrome |
| title_fullStr | Complete laboratory diagnosis of Insulin Autoimmune Syndrome |
| title_full_unstemmed | Complete laboratory diagnosis of Insulin Autoimmune Syndrome |
| title_short | Complete laboratory diagnosis of Insulin Autoimmune Syndrome |
| title_sort | complete laboratory diagnosis of insulin autoimmune syndrome |
| topic | Insulin C-peptide Insulin autoantibody Interference Insulin autoimmune syndrome Size exclusion chromatography |
| url | http://www.sciencedirect.com/science/article/pii/S2352551723000148 |
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