April - June 2021, Volume 17, Issue 2

Sima A, Vlad AR, Timar B, Cotoi L, Sima L, Vlad M, Timar R

Insulin Autoimmune Syndrome in a Young Caucasian Woman

Acta Endo (Buc) 2021, 17 (2): 248-250
doi: 10.4183/aeb.2021.248

A young Caucasian woman presents several episodes of severe fasting hypoglycemia. Fasting lab tests revealed: glycemia 28 mg/dL, insulinemia 143.3 μU/mL, insulin antibodies above 100 U/mL, leading to the diagnosis of insulin autoimmune syndrome. Due to lack of clinical improvement after 2 months, prednisone was started at 0.5 mg/kg/day, and then tapered by 5 mg every 5 days. Three weeks after discontinuing corticotherapy, the patient had no more severe fasting hypoglycemia, but occasionally postprandial mild hypoglycemia. Fasting lab tests showed: glycemia 83 mg/dL, insulinemia 58.6 μU/mL. At 5 hours during oral glucose tolerance test glycemia was 33 mg/dL, insulinemia 152.9 μU/mL.

Keywords: hypoglycemia, anti insulin antibodies, corticotherapy.

Correspondence: Adrian Radu Vlad MD, PhD, 3rd Internal Medicine Clinic, 10 B-dul dr. Iosif Bulbuca, Diabetes Clinic (6th floor), Timisoara, Timis County, 300736, Romania, E-mail: vlad.adrian@umft.ro