Insulin Autoimmune Syndrome: A Case Report Highlighting Diagnostic Pitfalls

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Aug 9

PMID 39119412

Authors

Hisatoshi Okumura

Satoshi Inaba

Atsushi Kawashima

Taro Shimizu

Affiliations

Soon will be listed here.

Abstract

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hyperinsulinemic hypoglycemia and the presence of insulin autoantibodies in high titers without exogenous insulin use. The C-peptide level during a hypoglycemia episode is useful for differentiating spontaneous hypoglycemia. Generally, low C-peptides are suspicious for exogenous insulin administration. We report a 47-year-old male nurse who presented with an initial episode of hypoglycemia. Despite the pattern of hyperinsulinemic hypoglycemia and low C-peptide, he was diagnosed with IAS based on the presence of insulin autoantibodies. This case underscores the importance of suspecting IAS in non-diabetic adults with hypoglycemia, even in the setting of low C-peptide levels.

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