Insulin Autoimmune Syndrome in an 89-year-old Woman: The Oldest Age of Onset Ever to Be Reported in Japan

DOI Web Site 18 References
  • Kondou Seiya
    Department of Diabetes and Metabolism, Koseiren Tsurumi Hospital Department of Internal Medicine, Usuki Cosmos Hospital
  • Hidaka Shuji
    Department of Diabetes and Metabolism, Koseiren Tsurumi Hospital
  • Kashima Jin
    Department of Diabetes and Metabolism, Koseiren Tsurumi Hospital Department of Internal Medicine 1, Faculty of Medicine, Oita University
  • Mitsutomi Kimihiko
    Department of Diabetes and Metabolism, Koseiren Tsurumi Hospital Department of Internal Medicine 1, Faculty of Medicine, Oita University
  • Fujitomi Yutaka
    Koseiren Tsurumi Hospital
  • Yoshimatsu Hironobu
    Department of Internal Medicine 1, Faculty of Medicine, Oita University

Bibliographic Information

Other Title
  • 本邦最高齢（89歳）で発症したインスリン自己免疫症候群の1例―1994年から2010年までに報告された120症例の臨床的特徴，既報との対比―
  • 症例報告 本邦最高齢(89歳)で発症したインスリン自己免疫症候群の1例 : 1994年から2010年までに報告された120症例の臨床的特徴,既報との対比
  • ショウレイ ホウコク ホンポウ サイコウレイ(89サイ)デ ハッショウ シタ インスリン ジコ メンエキ ショウコウグン ノ 1レイ : 1994ネン カラ 2010ネン マデ ニ ホウコク サレタ 120 ショウレイ ノ リンショウテキ トクチョウ,キホウ ト ノ タイヒ

Search this article

Abstract

On March 8th, 2007, an 89-year-old woman visited the hospital because of impaired consciousness. She was examined in the Department of Neurosurgery, and no abnormalities were found by physical examination or brain MRI. However, because she had a blood glucose level of 37 mg/dl, she was treated with an intravenous glucose infusion. Improvement of the glucose levels and symptoms were rapidly noticed after the treatment, and the patient was discharged. The next day, in the early morning, the patient presented to the ER complaining of similar neurological symptoms; an analysis of her blood glucose levels revealed hypoglycemia, and the patient was admitted for treatment and further evaluation. Hyperinsulinemia of 30151 μU/ml during hypoglycemia, anti-insulin antibodies of 62.5 %, no history of exogenous insulin use and a carrier state of DRB1*04:06, an HLA type commonly observed in patients with insulin autoimmune syndrome (IAS), confirmed the diagnosis of IAS, which made our patient the oldest ever diagnosed with IAS in Japan. In a previous report of 212 IAS cases from 1970 to 1993, there were no differences in the incidence between genders. However, this time we reported 120 IAS cases from 1994 to 2010, and the female cases of IAS have been increasing; this has been linked with the use of α lipoic acid, a known risk factor for drug-related IAS. Moreover, among the 120 cases, 17 cases were reported from elderly patients aged 75 or over, and interestingly, there were no cases of typical drug-related IAS induced by α lipoic acid or thiamazole; thereby, a lower incidence of drug-related IAS was noted in these patients compared with that in the younger patients. A corresponding bibliographic analysis accompanies this report.<br>

Journal

References(18)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top