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두 종류의 항체를 보유한 자가면역성 저혈당 1예

Other Titles
 A Case of Autoimmune Hypoglycemia in the Presence of Both Anti-insulin and Anti-insulin Receptor Antibodies 
Authors
 전성완  ;  이병완  ;  강은석  ;  차봉수  ;  이은직  ;  임승길  ;  이현철 
Citation
 Korean Clinical Diabetes (임상당뇨병), Vol.10(2) : 123-128, 2009 
Journal Title
 Korean Clinical Diabetes  (임상당뇨병) 
ISSN
 2233-7431 
Issue Date
2009
Abstract
Autoimmune hypoglycemia is rare kind of autoimmune disease caused by either anti-insulin antibodies (insulin autoimmune syndrome, IAS) or anti-insulin receptor antibodies (type B insulin resistance, type-B IR). We experienced an extremely rare case of the IAS accompanied by type-B IR. A 73-year-old woman presented with recurrent severe hypoglycemic symptoms at dawn for one month was admitted to the Severance hospital. She had several medical histories including 30 years of hypertension, 15 years of type 2 diabetes, and 4 years of coronary artery disease before admission. She had never received an insulin injection. Hypoglycemia was diagnosed at 10 hours in the 72-hour fasting test with glucose, insulin, and C-peptide levels of 42 mg/dL, 280.31 μU/mL, and 7.70 ng/mL, respectively. The insulin autoantibody titer was 130 μU/mL and quantitative assay for insulin receptor antibody was positive. Insulinoma was ruled out by imaging techniques and calcium stimulation test. She has no evidence of other diseases associated with altered immunity. Despite of treatment with prednisolone, symptomatic hypoglycemic events persisted at fasting state. Early induction of 300 mg cyclophosphamide therapy resulted in remission of hypoglycemia accompanied by suppressed antibody titer. The changes in autoantibodies might result in alleviation of the symptoms of hypoglycemia and improvement in insulin and C-peptide levels
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강은석(Kang, Eun Seok) ORCID logo https://orcid.org/0000-0002-0364-4675
이병완(Lee, Byung Wan) ORCID logo https://orcid.org/0000-0002-9899-4992
이은직(Lee, Eun Jig) ORCID logo https://orcid.org/0000-0002-9876-8370
이현철(Lee, Hyun Chul)
임승길(Lim, Sung Kil)
전성완(Chun, Sung Wan)
차봉수(Cha, Bong Soo) ORCID logo https://orcid.org/0000-0003-0542-2854
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104802
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