scholarly journals Insulin Autoimmune Syndrome Induced by α–Lipoic Acid in a Caucasian Woman: Case Report

Diabetes Care ◽  
2011 ◽  
Vol 34 (9) ◽  
pp. e146-e146 ◽  
Author(s):  
Enrico Bresciani ◽  
Anna Bussi ◽  
Elena Bazzigaluppi ◽  
Gianpaolo Balestrieri
Keyword(s):  
Case Report ◽  
Lipoic Acid ◽  
Caucasian Woman ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

Arare case of caucasian patient with insulin autoimmune syndrome induced by a-lipoic acid

2020 ◽  
Author(s):  
Spyridoula Glikofridi ◽  
Labrini Papanastasiou ◽  
Athina Markou ◽  
Vasileios Andrianesis ◽  
Christos Gravvanis ◽  
...  
Keyword(s):  
Lipoic Acid ◽  
Caucasian Patient ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

scholarly journals Primary insulin autoimmune syndrome in an Italian woman: a case report

2015 ◽  
Vol 9 (2) ◽  
pp. 169 ◽  
Author(s):  
Antonio Balestrieri ◽  
Elena Magnani ◽  
Cecilia Ragazzini ◽  
Giampiero Pasini
Keyword(s):  
Case Report ◽  
Insulin Antibodies ◽  
Total Serum ◽  
Immunoreactive Insulin ◽  
High Concentration ◽  
Hematological Diseases ◽  
Italian Woman ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome ◽  
Primary Form

Insulin autoimmune syndrome (IAS) is a rare syndrome characterized by fasting or postprandial hypoglycemia, high levels of anti-insulin antibodies and high concentration of total serum immunoreactive insulin. It is relatively known in Japan, rare in remaining Asia and it is extremely uncommon in Western countries, being characterized by a different race-related incidence and associated with HLADR4 alleles. Usually IAS is related to particular drugs, or to autoimmune, rheumatologic or hematological diseases, while it is very rare as a primary form. Here we described a case of an Italian woman affected by a primary form of Hirata syndrome.

scholarly journals Insulin autoimmune syndrome in an occidental woman: a case report and literature review

2018 ◽  
Vol 62 (5) ◽  
pp. 566-570 ◽  
Author(s):  
Mariella Zaiden Rezende Reis ◽  
Virgínia Oliveira Fernandes ◽  
Eveline Gadelha Pereira Fontenele ◽  
Ana Paula Abreu Martins Sales ◽  
Renan Magalhães Montenegro ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

scholarly journals Spontaneously remitting insulin autoimmune syndrome in a patient taking alpha-lipoic acid

2018 ◽  
Vol 2018 ◽  
Author(s):  
D Cappellani ◽  
C Sardella ◽  
M C Campopiano ◽  
A Falorni ◽  
P Marchetti ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Lipoic Acid ◽  
University Hospital ◽  
Hypoglycaemic Episode ◽  
List Type ◽  
Alpha Lipoic Acid ◽  
Previous Exposure ◽  
Hyperinsulinaemic Hypoglycaemia ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

Summary Insulin autoimmune syndrome (IAS), or Hirata disease, is a rare hypoglycaemic disorder caused by the presence of high titer of insulin autoantibodies (IAA) in patients without previous exposure to exogenous insulin. Even though its pathogenesis is not fully understood, striking evidences link IAS to previous exposure to sulphydryl-containing medications, like alpha-lipoic acid, a widely used nutritional supplement. Although challenging, a careful differential diagnosis from other causes of hyperinsulinaemic hypoglycaemia (such as insulinoma) is mandatory, since these conditions require different therapeutic approaches. In the present study, we report a 35-year-old woman originally from Sri Lanka who was referred to our University Hospital on suspicion of occult insulinoma. Her medical history was positive for endometriosis, treated with estroprogestins and alpha-lipoic acid. The latter supplement was begun 2 weeks before the first hypoglycaemic episode. Our tests confirmed the presence of hypoglycaemia associated with high insulin and C-peptide concentrations. When insulin concentrations were compared using different assays, the results were significantly different. Moreover, insulin values significantly decreased after precipitation with polyethylene glycol. An assay for IAA proved positive (530 U/mL). A genetic analysis revealed the presence of HLA-DRB1*04,15, an immunogenetic determinant associated with IAS. On the basis of clinical data we avoided a first-line approach with immunosuppressive treatments, and the patient was advised to modify her diet, with the introduction of frequent low-caloric meals. During follow-up evaluations, glucose levels (registered trough a flash glucose monitoring system) resulted progressively more stable. IAA titer progressively decreased, being undetectable by the fifteenth month, thus indicating the remission of the IAS. Learning points: Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinaemic hypoglycaemia, whose prevalence is higher in East Asian populations due to the higher prevalence of specific immunogenetic determinants. Nevertheless, an increasing number of IAS cases is being reported worldwide, due to the wide diffusion of medications such as alpha-lipoic acid. Differential diagnosis of IAS from other causes of hyperinsulinemic hypoglycaemia is challenging. Even though many tests can be suggestive of IAS, the gold standard remains the detection of IAAs, despite that dedicated commercial kits are not widely available. The therapeutic approach to IAS is problematic. As a matter of fact IAS is often a self-remitting disease, but sometimes needs aggressive immunosuppression. The benefits and risks of any therapeutic choice should be carefully weighted and tailored on the single patient.

Reactive hypoglycemic coma due to insulin autoimmune syndrome: Case report and literature review

1992 ◽  
Vol 92 (6) ◽  
pp. 681-685 ◽  
Author(s):  
Henry B. Burch ◽  
Stephen Clement ◽  
Michael S. Sokol ◽  
Frank Landry
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Hypoglycemic Coma ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

Possible relevance of alpha lipoic acid contained in a health supplement in a case of insulin autoimmune syndrome

2007 ◽  
Vol 75 (3) ◽  
pp. 366-367 ◽  
Author(s):  
Noboru Furukawa ◽  
Nobuhiro Miyamura ◽  
Kenro Nishida ◽  
Hiroyuki Motoshima ◽  
Kayo Taketa ◽  
...  
Keyword(s):  
Lipoic Acid ◽  
Alpha Lipoic Acid ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome

scholarly journals Insulin Autoimmune Syndrome PossiblyCaused by Alpha Lipoic Acid

2007 ◽  
Vol 46 (5) ◽  
pp. 237-239 ◽  
Author(s):  
Yuichiro Takeuchi ◽  
Takahide Miyamoto ◽  
Tomoko Kakizawa ◽  
Satoshi Shigematsu ◽  
Kiyoshi Hashizume
Keyword(s):  
Lipoic Acid ◽  
Alpha Lipoic Acid ◽  
Insulin Autoimmune Syndrome ◽  
Autoimmune Syndrome
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