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Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus

The association of type B insulin resistance syndrome (TBIRS) due to autoimmune diseases such as systemic lupus erythematosus (SLE) is uncommon. This is partly due to the lack of established criteria for the diagnosis of this resistance. However, some clinical aspects may suggest that the diagnosis...

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Autores principales: Alvarez-Payares, José C., Ribero, Daniel, Rodríguez, Luis, Builes, Carlos E., Prieto, Carolina, Arango, Clara, Gamboa, Juan G., Alvarez-Payares, Cristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586807/
https://www.ncbi.nlm.nih.gov/pubmed/36275943
http://dx.doi.org/10.1155/2022/4655804
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author Alvarez-Payares, José C.
Ribero, Daniel
Rodríguez, Luis
Builes, Carlos E.
Prieto, Carolina
Arango, Clara
Gamboa, Juan G.
Alvarez-Payares, Cristian
author_facet Alvarez-Payares, José C.
Ribero, Daniel
Rodríguez, Luis
Builes, Carlos E.
Prieto, Carolina
Arango, Clara
Gamboa, Juan G.
Alvarez-Payares, Cristian
author_sort Alvarez-Payares, José C.
collection PubMed
description The association of type B insulin resistance syndrome (TBIRS) due to autoimmune diseases such as systemic lupus erythematosus (SLE) is uncommon. This is partly due to the lack of established criteria for the diagnosis of this resistance. However, some clinical aspects may suggest that the diagnosis does not necessarily have to be positive insulin receptor antibodies as such patients could respond to immunosuppressive treatment. Methods. We describe a case and have performed a literature review on PubMed/MEDLINE, EMBASE, and Google Scholar bibliographic databases to identify all case reports. All available studies from January 1975 through December 2020 were included. Data collected were tabulated, and outcomes were analyzed cumulatively. Results. Thirty-one cases of TBIRS associated with SLE have been described. These patients presented with catabolic symptoms and hyperglycemia in most cases, with an average time from the onset of symptoms of four months. In addition to that clinical characteristics related to SLE were variable, along with certain common characteristics such as acanthosis in 60% of patients. Almost all the patients had antibodies against insulin receptors. The insulin doses required by the patients ranged from 450 to 25,000 U daily. Remission was achieved in 80% of the patients with a two-year follow-up. Most patients associated with late-onset SLE, like our patient, achieved metabolic control after immunosuppressive treatment. Conclusion. High insulin resistance in patients with de novo diabetes mellitus (DM) without obesity should be considered as a possible clinical manifestation of an autoimmune disease such as SLE, with a good metabolic response to the immunosuppressive management established.
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spelling pubmed-95868072022-10-22 Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus Alvarez-Payares, José C. Ribero, Daniel Rodríguez, Luis Builes, Carlos E. Prieto, Carolina Arango, Clara Gamboa, Juan G. Alvarez-Payares, Cristian Case Rep Med Case Report The association of type B insulin resistance syndrome (TBIRS) due to autoimmune diseases such as systemic lupus erythematosus (SLE) is uncommon. This is partly due to the lack of established criteria for the diagnosis of this resistance. However, some clinical aspects may suggest that the diagnosis does not necessarily have to be positive insulin receptor antibodies as such patients could respond to immunosuppressive treatment. Methods. We describe a case and have performed a literature review on PubMed/MEDLINE, EMBASE, and Google Scholar bibliographic databases to identify all case reports. All available studies from January 1975 through December 2020 were included. Data collected were tabulated, and outcomes were analyzed cumulatively. Results. Thirty-one cases of TBIRS associated with SLE have been described. These patients presented with catabolic symptoms and hyperglycemia in most cases, with an average time from the onset of symptoms of four months. In addition to that clinical characteristics related to SLE were variable, along with certain common characteristics such as acanthosis in 60% of patients. Almost all the patients had antibodies against insulin receptors. The insulin doses required by the patients ranged from 450 to 25,000 U daily. Remission was achieved in 80% of the patients with a two-year follow-up. Most patients associated with late-onset SLE, like our patient, achieved metabolic control after immunosuppressive treatment. Conclusion. High insulin resistance in patients with de novo diabetes mellitus (DM) without obesity should be considered as a possible clinical manifestation of an autoimmune disease such as SLE, with a good metabolic response to the immunosuppressive management established. Hindawi 2022-10-14 /pmc/articles/PMC9586807/ /pubmed/36275943 http://dx.doi.org/10.1155/2022/4655804 Text en Copyright © 2022 José C. Alvarez-Payares et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Alvarez-Payares, José C.
Ribero, Daniel
Rodríguez, Luis
Builes, Carlos E.
Prieto, Carolina
Arango, Clara
Gamboa, Juan G.
Alvarez-Payares, Cristian
Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title_full Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title_fullStr Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title_full_unstemmed Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title_short Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
title_sort late systemic lupus erythematosus-associated insulin resistance syndrome: a rare cause of de novo diabetes mellitus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586807/
https://www.ncbi.nlm.nih.gov/pubmed/36275943
http://dx.doi.org/10.1155/2022/4655804
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