Insulin autoimmunity as a cause of hypoglycemia

• Published in: Archives of internal medicine (1960) Vol. 144; no. 12; p. 2351
• Main Authors: Benson, E A, Ho, P, Wang, C, Wu, P C, Fredlund, P N, Yueng, R T
• Format: Journal Article
• Language: English
• Published: United States 01.12.1984
• Subjects: Autoantibodies - physiology; Diagnosis, Differential; Female; Humans; Hyperplasia; Hypoglycemia - etiology; Hypoglycemia - immunology; Hypoglycemia - pathology; Insulin Antibodies - physiology; Insulinoma - pathology; Islets of Langerhans - immunology; Islets of Langerhans - pathology; Male; Methimazole - adverse effects; Middle Aged; Pancreatic Neoplasms - pathology; Penicillamine - adverse effects; Syndrome
• ISSN: 0003-9926
• DOI: 10.1001/archinte.1984.00350220067015

"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.