Long-term follow-up after discharge witnesses a slow decline of insulin autoantibodies in patients with insulin autoimmune syndrome complicated with Grave's disease: a report of two cases.
Genotype test
Grave’s disease
Hypoglycemia
Insulin autoimmune syndrome
Iodine therapy
Journal
BMC endocrine disorders
ISSN: 1472-6823
Titre abrégé: BMC Endocr Disord
Pays: England
ID NLM: 101088676
Informations de publication
Date de publication:
17 Aug 2023
17 Aug 2023
Historique:
received:
21
11
2022
accepted:
11
07
2023
medline:
18
8
2023
pubmed:
17
8
2023
entrez:
16
8
2023
Statut:
epublish
Résumé
Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia characterized by high levels of blood insulin autoantibodies. It has been documented that drugs containing sulfhydryl groups may result in IAS. In this study, we present two cases of IAS induced by methimazole, along with their corresponding treatments and a long-term follow-up after hospitalization. We report two patients with Grave's disease (GD), carrying the HLA-DRB1 04:06 genotype, who experienced hypoglycemic episodes after taking methimazole. Inpatient treatments helped return their blood glucose levels to normal. Although no recurrences of hypoglycemia were present in the two cases studied, insulin autoantibodies remained positive for the previous follow-up sessions, which turned negative only three years after discharge. GD patients who carry the HLA-DRB1 04:06 genotype are prone to IAS if they take drugs containing sulfhydryl groups. It may take time for the elimination of insulin autoantibodies after the recovery from the hypoglycemic episode in IAS patients.
Sections du résumé
BACKGROUND
BACKGROUND
Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia characterized by high levels of blood insulin autoantibodies. It has been documented that drugs containing sulfhydryl groups may result in IAS. In this study, we present two cases of IAS induced by methimazole, along with their corresponding treatments and a long-term follow-up after hospitalization.
CASE PRESENTATION
METHODS
We report two patients with Grave's disease (GD), carrying the HLA-DRB1 04:06 genotype, who experienced hypoglycemic episodes after taking methimazole. Inpatient treatments helped return their blood glucose levels to normal. Although no recurrences of hypoglycemia were present in the two cases studied, insulin autoantibodies remained positive for the previous follow-up sessions, which turned negative only three years after discharge.
CONCLUSIONS
CONCLUSIONS
GD patients who carry the HLA-DRB1 04:06 genotype are prone to IAS if they take drugs containing sulfhydryl groups. It may take time for the elimination of insulin autoantibodies after the recovery from the hypoglycemic episode in IAS patients.
Identifiants
pubmed: 37587407
doi: 10.1186/s12902-023-01410-6
pii: 10.1186/s12902-023-01410-6
pmc: PMC10433660
doi:
Substances chimiques
HLA-DRB1 Chains
0
Methimazole
554Z48XN5E
Autoantibodies
0
Sulfhydryl Compounds
0
Hypoglycemic Agents
0
Insulins
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
177Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
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