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부분 뇌하수체기능저하증을 동반한 인슐린자가면역증후군 1예

Other Titles
 A Case of Insulin Autoimmune Syndrome in a Patient with Partial Hypopituitarism 
Authors
 권오빈  ;  박은영  ;  윤진영  ;  김광준  ;  이용호  ;  홍재원  ;  이은직  ;  임승길  ;  이현철  ;  차봉수 
Citation
 Endocrinology and Metabolism (대한내분비학회지), Vol.24(4) : 281-286, 2009 
Journal Title
 Endocrinology and Metabolism (대한내분비학회지) 
ISSN
 2093-596X 
Issue Date
2009
Keywords
corticosteroid ; hypopituitarism ; insulin autoimmune syndrome
Abstract
Insulin autoimmune syndrome is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemic hypoglycemia associated with high titer of antibodies to endogenous insulin. We report a case of insulin autoimmune syndrome in a 57-year-old woman, presenting with mental changes due to hypoglycemia. She had no history of diabetes or insulin administration. The serum C-peptide level was 4.69 ng/mL and the insulin concentration was 229.55 μU/mL, when fasting plasma glucose level was 32 mg/dL. The insulin-to-glucose ratio was 7.17, while there was no radiologic evidence of insulinoma. The insulin antibody level was over 100 μU/mL, resulting in the diagnosis of insulin autoimmune syndrome. Hormonal studies revealed partial hypopituitarism and a lack of glucagon-response to hypoglycemia. Hypoglycemia disappeared with replacement of prednisolone with levothyroxine therapy. Under secretion of growth hormone and of adrenocorticotropic hormone due to hypopituitarism were associated with insufficient counterregulation to hypoglycemia. One should keep in mind that insulin autoimmune syndrome or hypopituitarism is one cause of hypoglycemia in patients with no history of diabetes, and corticosteroid can be an effective treatment for both diseases.
Files in This Item:
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DOI
10.3803/jkes.2009.24.4.281
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김광준(Kim, Kwang Joon) ORCID logo https://orcid.org/0000-0002-5554-8255
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
이은직(Lee, Eun Jig) ORCID logo https://orcid.org/0000-0002-9876-8370
이현철(Lee, Hyun Chul)
임승길(Lim, Sung Kil)
차봉수(Cha, Bong Soo) ORCID logo https://orcid.org/0000-0003-0542-2854
홍재원(Hong, Jae Won)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163851
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