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말기신부전환자에서 인슐린항체에 의한 자가면역성 저혈당증 1예

Other Titles
 A Case of Autoimmune Hypoglycemia due to Insulin Antibody in Patient with End Stage Renal Disease 
Authors
 정지예  ;  강은석  ;  김범석  ;  전성완  ;  이유미  ;  안철우  ;  차봉수  ;  이은직  ;  임승길  ;  이현철 
Citation
 Journal of Korea Society of Endocrinology (대한내분비학회지), Vol.21(6) : 536-541, 2006 
Journal Title
 Journal of Korea Society of Endocrinology (대한내분비학회지) 
ISSN
 1015-6380 
Issue Date
2006
Keywords
Autoimmune hypoglycemia ; End stage renal disease ; Insulin antibody
Abstract
Fasting hypoglycemia results from several mechanisms. Autoimmune hypoglycemia is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemia, fasting hypoglycemia and the presence of autoantibodies to insulin or insulin receptor. We report here on a 64-year-old male patient with autoimmune hypoglycemia with end stage renal disease. He had no history of diabetes or insulin use. He had experienced several severe hypoglycemic events. The serum C-peptide level was 7.48 ng/mL and the insulin concentration was 115.4 uU/mL when the fasting plasma glucose level was 88 mg/dL. The insulin to glucose ratio was 5.42, which suggested the presence of insulinoma. Yet the radiologic studies, including magnetic resonance cholangiopancreatography, endoscopic ultrasonography and selective calcium stimulated venous sampling revealed no evidence of insulinoma. The insulin autoantibody level was 62 µU/mL. Therefore, we could diagnosis the autoimmune hypoglycemia. The hypoglycemia was treated with prednisolone and the patient recovered from this. His insulin level decreased to 21.11 µU/mL and the insulin autoantibody level decreased to 34 µU/mL. Hypoglycemia in the hemodialysis patients is not uncommon. One should bear in mind autoimmune hypoglycemia as one of the causes of hypoglycemia in patients with no history of diabetes.
Files in This Item:
T200601383.pdf Download
DOI
10.3803/jkes.2006.21.6.536
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Lee, Hyun Chul(이현철)
Lim, Sung Kil(임승길)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110369
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