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Insulin autoimmune syndrome in a pregnant female: A rare case report

RATIONALE: Insulin autoimmune syndrome (IAS) is an uncommon disorder characterized by hyperinsulinemic hypoglycemia related to insulin-binding autoantibodies. To the best of our knowledge, we report the first case of a pregnant female with IAS. PATIENT CONCERNS: The 26-year-old patient with Graves d...

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Autores principales: Zeng, Xiang Xia, Tang, Yun Liang, Hu, Kai Xiang, Wang, Jiao, Zhu, Ling Yan, Liu, Jian Ying, Xu, Jix Iong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758171/
https://www.ncbi.nlm.nih.gov/pubmed/29390469
http://dx.doi.org/10.1097/MD.0000000000009213
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author Zeng, Xiang Xia
Tang, Yun Liang
Hu, Kai Xiang
Wang, Jiao
Zhu, Ling Yan
Liu, Jian Ying
Xu, Jix Iong
author_facet Zeng, Xiang Xia
Tang, Yun Liang
Hu, Kai Xiang
Wang, Jiao
Zhu, Ling Yan
Liu, Jian Ying
Xu, Jix Iong
author_sort Zeng, Xiang Xia
collection PubMed
description RATIONALE: Insulin autoimmune syndrome (IAS) is an uncommon disorder characterized by hyperinsulinemic hypoglycemia related to insulin-binding autoantibodies. To the best of our knowledge, we report the first case of a pregnant female with IAS. PATIENT CONCERNS: The 26-year-old patient with Graves disease and 10 weeks pregnant developed IAS after approximately 6 months treatment with methimazole. The patient exhibited recurrent spontaneous hypoglycemia. DIAGNOSES: On evaluation, laboratory findings detected both high fasting insulin (>1000 mIU/L) and insulin autoantibodies. An oral glucose tolerance test showed elevated insulin concentrations with disproportionately elevated C-peptide levels. The imaging study showed nomasslesionsinthepancreas,and the patient was clinically diagnosed with IAS. INTERVENTIONS: The patient had an abortion, discontinued methimazole and switched to oral prednisone (30 mg once daily) and propylth- iouracil (100 mg 3 times daily) for 3 months. OUTCOMES: At the 3-month follow-up visit, hypoglycemic episodes had disappeared and insulin antibody levels were no longer detectable. LESSONS: We have described this case and reviewed the relevant literature concerning diagnosis and treatment of IAS. Importantly, this case indicates that clinicians should view pregnancy as another factor of hypoglycemia in IAS.
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spelling pubmed-57581712018-01-29 Insulin autoimmune syndrome in a pregnant female: A rare case report Zeng, Xiang Xia Tang, Yun Liang Hu, Kai Xiang Wang, Jiao Zhu, Ling Yan Liu, Jian Ying Xu, Jix Iong Medicine (Baltimore) 4300 RATIONALE: Insulin autoimmune syndrome (IAS) is an uncommon disorder characterized by hyperinsulinemic hypoglycemia related to insulin-binding autoantibodies. To the best of our knowledge, we report the first case of a pregnant female with IAS. PATIENT CONCERNS: The 26-year-old patient with Graves disease and 10 weeks pregnant developed IAS after approximately 6 months treatment with methimazole. The patient exhibited recurrent spontaneous hypoglycemia. DIAGNOSES: On evaluation, laboratory findings detected both high fasting insulin (>1000 mIU/L) and insulin autoantibodies. An oral glucose tolerance test showed elevated insulin concentrations with disproportionately elevated C-peptide levels. The imaging study showed nomasslesionsinthepancreas,and the patient was clinically diagnosed with IAS. INTERVENTIONS: The patient had an abortion, discontinued methimazole and switched to oral prednisone (30 mg once daily) and propylth- iouracil (100 mg 3 times daily) for 3 months. OUTCOMES: At the 3-month follow-up visit, hypoglycemic episodes had disappeared and insulin antibody levels were no longer detectable. LESSONS: We have described this case and reviewed the relevant literature concerning diagnosis and treatment of IAS. Importantly, this case indicates that clinicians should view pregnancy as another factor of hypoglycemia in IAS. Wolters Kluwer Health 2017-12-22 /pmc/articles/PMC5758171/ /pubmed/29390469 http://dx.doi.org/10.1097/MD.0000000000009213 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4300
Zeng, Xiang Xia
Tang, Yun Liang
Hu, Kai Xiang
Wang, Jiao
Zhu, Ling Yan
Liu, Jian Ying
Xu, Jix Iong
Insulin autoimmune syndrome in a pregnant female: A rare case report
title Insulin autoimmune syndrome in a pregnant female: A rare case report
title_full Insulin autoimmune syndrome in a pregnant female: A rare case report
title_fullStr Insulin autoimmune syndrome in a pregnant female: A rare case report
title_full_unstemmed Insulin autoimmune syndrome in a pregnant female: A rare case report
title_short Insulin autoimmune syndrome in a pregnant female: A rare case report
title_sort insulin autoimmune syndrome in a pregnant female: a rare case report
topic 4300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758171/
https://www.ncbi.nlm.nih.gov/pubmed/29390469
http://dx.doi.org/10.1097/MD.0000000000009213
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