Recurrent Postprandial Hypoglycaemia in Insulin Autoimmune Syndrome
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 8
Abstract
ABSTRACT Insulin autoimmune hypoglycaemia syndrome (IAS) is not a common entity. It is characterised by auto-antibodies to endogenous insulin in persons without previous exposure to exogenous insulin. IAS is relatively common cause of spontaneous hypoglycaemia in Japan (third most common cause of hypoglycaemia). First case in India was reported in 2013. Since then only four cases of IAS have been reported so far. The present case is about a middle aged Indian male, who presented with spontaneous, recurrent postprandial hypoglycaemia. He had palpitations, sweating, tremor of hands, feeling of hunger 2-5 hours after meal. He got relief by taking sweets, sugar or orange juice. Estimation of anthropological parameters revealed his BMI to be 28.5 kg/m2. Laboratory findings of serum glucose were 52 mg/dL, serum Insulin >1000 units/mL, Connecting peptide 14.56 ng/mL, Serum Insulin antibody level was >300 units/mL. He was a non-diabetic with HbA1C 5.63%: Rise of serum cortisol was appropriate for hypoglycaemic stress. A diagnosis of IAS was made. He was put on steroid which was tapered in three months. The patient was advised frequent low carbohydrate meals. His symptoms subsided in six moths and after one year all his hormonal parameters returned to normal. Spontaneous hypoglycaemia with unusually high serum Insulin, high C-Peptide and presence of insulin auto antibodies are strongly suggestive of IAS.
Authors and Affiliations
Suresh Kumar Sinha, Kalyan Gaud, Rajashekar Mummadi
An Additional Visceral Impression on Spleen – A Rare Anatomical Scenario
An accessory spleen is a small mass of splenic tissue, found apart from main body. An unexpectedly rare location of accessory spleen in phrenicocolic ligament was encountered during the course of preclinical cadaveric di...
Clinico Pathological Analysis of Uterine Serous Carcinoma in a Cancer Centre from Northern Kerala-A Retrospective Study
ABSTRACT Introduction: Uterine Serous Carcinoma (USC) accounts for 10% of malignancies of uterine corpus. They are characterised by high propensity for local spread, extra uterine metastasis, recurrence and are having po...
Anaplastic Carcinoma Occurring in a Longstanding Multinodular Goitre Diagnosed by FNAC: A Rare Case
ABSTRACT Anaplastic Thyroid Carcinoma (ATC) remains one of the most virulent of all cancers in humans with a survival rate of only 1%. The widespread use of Fine Needle Aspiration Cytology (FNAC) has significantly change...
Magnetic Resonance Imaging Evaluation of Central Nervous System Manifestations in Patients Infected with Human Immunodeficiency Virus
Introduction: Involvement of Central Nervous System (CNS) occurs early in Human Immunodeficiency Virus (HIV) infection resulting in significant morbidity and mortality. In these patients, neuroimaging is the modality of...
Expression of Angiogenic Factors in Psoriasis Vulgaris
Introduction: Psoriasis is a chronic inflammatory skin disease characterized by epidermal hyperproliferation, abnormal differentiation and inflammatory infiltration in the dermis. The dermal microvascular expansion assoc...