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Insulin Autoimmunity as a Cause of Hypoglycemia
Edward A. Benson, MD;
Patricia Ho, BSc;
Christina Wang, MD;
P. C. Wu, MB, BS;
Paul N. Fredlund, MD;
Rose T. T. Yueng, MD
Arch Intern Med. 1984;144(12):2351-2354.
Abstract
• "Autoimmune" hypoglycemia is a syndrome consisting of fasting hypoglycemia, hyperinsulinemia, and insulin-binding antibodies in a patient who has never been exposed to exogenous insulin. The stimulus for insulin-antibody formation and the mechanism of the hypoglycemia in this condition remain unknown. Three patients with this rare syndrome had severe hypoglycemia of limited duration. Two had received a drug containing a sulfhydryl group (methimazole and penicillamine) as treatment for an autoimmune disorder (Graves' disease and rheumatoid arthritis, respectively). A third patient who underwent surgery for a suspected insulinoma was found to have pancreatic beta cell hyperplasia. Drugs containing a sulfhydryl group may have a role in the etiology of the syndrome. Additionally, our findings suggest a relationship between circulating insulin antibodies and beta cell hyperplasia.
(Arch Intern Med 1984;144:2351-2354)
Author Affiliations
From the Departments of Medicine, (Ms Ho and Drs Wang and Yueng) and Pathology (Dr Wu), Queen Mary Hospital, Hong Kong; and the Mason Clinic, Seattle (Drs Benson and Fredlund).
Footnotes
Accepted for publication March 26, 1984.
Reprint requests to the Mason Clinic, 1100 Ninth Ave, PO Box 900, Seattle, WA 98111 (Dr Benson).
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