Insulin Autoimmune Syndrome (Hirata Disease) After Treatment With Alpha-Lipoic Acid: A Case Report
We present the case of a 79-year-old White woman with recurrent spontaneous hypoglycemia characterized by low plasma glucose, inappropriately elevated plasma C-peptide and insulin levels, and the presence of antibodies against endogenous insulin. Imaging for insulinoma was negative. The diagnosis of...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American College of Physicians
2024-07-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2023.1485 |
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| Summary: | We present the case of a 79-year-old White woman with recurrent spontaneous hypoglycemia characterized by low plasma glucose, inappropriately elevated plasma C-peptide and insulin levels, and the presence of antibodies against endogenous insulin. Imaging for insulinoma was negative. The diagnosis of insulin autoimmune syndrome, or Hirata disease, was established. Continuous glucose monitoring data were consistent with the pathophysiology of insulin autoimmune syndrome. It was associated with the patient's previous treatment with an oral supplement containing alpha-lipoic acid. Frequent, small, low carbohydrate–content meals resulted in the elimination of hypoglycemic events. |
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| ISSN: | 2767-7664 |