Late postprandial hypoglycemia due to bioactive insulin dissociation from autoantibody leading to unconsciousness in a patient with insulin autoimmune syndrome.

@article{Nasu2011LatePH,
  title={Late postprandial hypoglycemia due to bioactive insulin dissociation from autoantibody leading to unconsciousness in a patient with insulin autoimmune syndrome.},
  author={Tetsushi Nasu and Ryoko Suzuki and Yoshihisa Okamoto and Kaori Miyata and Akiko Uno and Ryutaro Nakao and Akira Kawashima and Taisei Nakao and Michi Kondo},
  journal={Internal medicine},
  year={2011},
  volume={50 4},
  pages={339-43}
}
We report here the case of an 83-year-old man who was treated for unconsciousness and hypoglycemia (39 mg/dL) accompanied by marked elevation of serum immunoreactive insulin (IRI) (4,760 µIU/mL). We diagnosed his condition as insulin autoimmune syndrome (IAS, Hirata disease) because of a high insulin autoantibody (IAA) titer (>90%: bound/total) and no history of exogenous insulin administration. Reactive hypoglycemia occurred due to immediate association followed by dissociation between insulin… CONTINUE READING