Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease

특이 병력 없는 젊은 여성에게서 알파리포산 투약 후 발생한 인슐린자가면역증후군

  • Lee, Sang Bae (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Min Young (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • You, Ji Hong (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Seong Han (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Nam, Ji Sun (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 이상배 (연세대학교 의과대학 내과학교실) ;
  • 이민영 (연세대학교 의과대학 내과학교실) ;
  • 유지홍 (연세대학교 의과대학 내과학교실) ;
  • 김성한 (연세대학교 의과대학 내과학교실) ;
  • 남지선 (연세대학교 의과대학 내과학교실)
  • Received : 2016.06.21
  • Accepted : 2016.08.02
  • Published : 2017.06.30
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Abstract

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

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References

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