Clinical case of hypoglycemia due to Insulin autoimmune syndrome
Main Article Content
Abstract
Insulin autoimmune syndrome is characterized by hyperinsulinemic hypoglycemia, elevated insulin autoantibody (IAA) titers, no prior exposure to exogenous insulin, no pathological abnormalities of pancreatic islets. This is a rare cause of hypoglycemia, more commonly report in Asian countries. A case of 58-year-old male patient was diagnosed as hypoglycemia due to insulin autoimmune syndrome at Ha Noi Medical University Hospital in December 2020. The patient was admitted to the hospital because of coma due to hypoglycemia, Insulin and C-peptide levels was elevated. Lesion in the isthmus of the pancreas on magnetic resonance imaging which was misdiagnosised as insulinoma lead to our error in diagnosing the cause of hypoglycemia. Therefore, hypoglycemia, insulin and C-peptide levels did not improve after resection of the pancreatic lesion. Finally, the patient was diagnosed as insulin autoimmune syndrome and successfully treated by Glucocorticoid combination with a carbonhydrat restricted diet and divided meals.
Article Details
Keywords
Hypoglycemia, Endogenous hyperinsulinemia, Insulin autoimmune syndrome (IAS), Insulinoma, Nesidioblastosis.
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