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
Keywords
Related Articles
- EP ID EP639654
- DOI 10.7860/JCDR/2019/41863.13074
- Views 117
- Downloads 0
Large Ulcerated Oral Focal Mucinosis: A Rare Case Report
Images in Medicine
Evaluation of Microleakage with Total Etch, Self Etch and Universal Adhesive Systems in Class V Restorations: An In vitro Study
Introduction: Adhesive dentistry is overwhelmingly evolving with respect to the dental surgeon’s and patient’s perspective. Embracing the concept of minimally invasive dentistry which follows minimum intervention perform...
A Case Report of Rituximab Induced Angioedema
ABSTRACT Rituximab is a genetically engineered chimeric murine/human monoclonal IgG1 kappa antibody directed against the CD20 antigen. It has been approved for rheumatoid arthritis and is a promising new agent in the tre...
Evaluation and Comparison of Blood Parameters in Diabetic Patients with and without Peripheral Neuropathy
Introduction: Diabetic Peripheral Neuropathy (DPN) is the most prevalent and troublesome microvascular complication (50%) of Diabetes Mellitus (DM). The factors involved in the pathogenesis of diabetic neuropathy have no...
Evaluation of IOTA Simple Ultrasound Rules to Distinguish Benign and Malignant Ovarian Tumours
Introduction: IOTA stands for International Ovarian Tumour Analysis group. Ovarian cancer is one of the common cancers in women and is diagnosed at later stage in majority. The limiting factor for early diagnosis is lack...