Síndrome de hipoglicemia autoinmune. Primeros casos en Chile
Author
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Lanas Montecinos, Alejandra
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Paredes, Ana
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Espinosa, Consuelo
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Caamaño, Edgardo
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Pérez Bravo, Francisco
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Pinto, Rodrigo
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Iñíguez Vila, Germán
Author
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Martínez, Darío
Author
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Soto, Néstor
Admission date
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2015-11-30T14:16:36Z
Available date
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2015-11-30T14:16:36Z
Publication date
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2015
Cita de ítem
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Rev Med Chile 2015; 143: 938-942
en_US
Identifier
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DOI: 10.4067/S0034-98872015000700016
Identifier
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https://repositorio.uchile.cl/handle/2250/135335
General note
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Artículo de publicación ISI
en_US
Abstract
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Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia with extremely high insulin levels and the presence of circulating autoantibodies against insulin, in patients who have never been exposed to exogenous insulin. We report two patients with the syndrome. A 36 years old male presenting with hypoglycemia in the emergency room had an oral glucose tolerance test showed basal and 120 min glucose levels of 88 and 185 mg/dl. The basal and 120 min insulin levels were 2,759 and 5,942 μUI/ml. The presence of an insulin secreting tumor was discarded. Anti-insulin antibodies were positive. He was successfully treated with a diet restricted in carbohydrates and frequent meals in small quantities. A 65 years old female presenting with hypoglycemia in the emergency room had the fasting insulin levels of 1,910 µUI/ml. No insulin secreting tumor was detected by images and anti-insulin antibodies were positive. The polyethylene glycol precipitation test showed a basal and after exposition insulin level 1,483 and 114 µUI/ml, respectively. She responded partially to diet and acarbose and required the use of prednisone with a good clinical response.