Two Cases of Autoimmune Insulin Syndrome with Hypoglycemia.

Park, See Hyung; Lee, Shin Won; Jeong, Gui Hwa; Choi, Chang Hoon; Lee, Soon Hee; Han, Jeung Hoon; Kim, Jeong Guk; Ha, Seong Woo; Kim, Bo Wan

Case Report

Journal of Korean Endocrine Society 2001;16(4-5):508-513.
Published online October 1, 2001.

Two Cases of Autoimmune Insulin Syndrome with Hypoglycemia.

See Hyung Park, Shin Won Lee, Gui Hwa Jeong, Chang Hoon Choi, Soon Hee Lee, Jeung Hoon Han, Jeong Guk Kim, Seong Woo Ha, Bo Wan Kim

Department of Internal Medicine, Kyungpook National University School of Medicine, Taegu, Korea.

Abstract

Autoimmune insulin syndrome is characterized by insulin autoantibody, hyperinsulinemia, and fasting hypoglycemia without previous insulin immunization. This syndrome shows discordant levels between immunoreactive insulin and C-peptide. Negative results of an anatomic study of the pancreas and an inability to reproduce hypoglycemia during a prolonged fast may be helpful in excluding insulinoma. Symptomatic hypoglycemia usually develops during an oral glucose tolerance test. This syndrome is a self-limited disorder. Recently, we experienced one case that developed symptomatic hypoglycemia during both the fasting & oral glucose tolerance test, and another that developed symptomatic hypoglycemia during the oral glucose tolerance test but not the fasting test. Hereby, we present these cases with a review of the literature.

Key Words: Insulin autoantibody, Hyperinsulinemia, Hypoglycemia