Keywords
Autoimmune diseases
insulin antibodies
methimazole
insulin autoimmune syndrome
autoimmunity
insulin
How to Cite
Abstract
Background: Autoimmune insulin syndrome, previously known as 'Hirata Syndrome', is a process that conditions the presence of endogenous antibodies against insulin in patients without previous exposure to exogenous insulin and with anatomically normal pancreas, which is characterized by the spontaneous appearance of episodes of hyperinsulinemic hypoglycemia.
Purpose: Contribute to raising awareness of this adverse effect of medications in order to inform about its existence to achieve an early diagnosis.
Case presentation: We present the case of a young 34-year-old patient who had Graves' Disease and was treated with methimazole, with subsequent development of episodes of hyperinsulinemic hypoglycemia, associated with the presence of autoantibodies against insulin, which resolved spontaneously with steroid management.
Discussion and conclusion: The diagnosis of this syndrome is based on the presence of autoantibodies against insulin. Cases associated with the ingestion of medications whose chemical component has the presence of sulfhydryl groups such as Methimazole have been described. Its normal evolution is towards spontaneous resolution and currently there is no clarity regarding the best therapeutic approach due to its low frequency and the few data registered in this regard.
Insulin autoimmunity syndrome is a rare entity which requires high clinical suspicion and, if possible, an attempt should be made to identify a triggering agent.
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