PMID- 24396698
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140107
LR  - 20211021
IS  - 2093-596X (Print)
IS  - 2093-5978 (Electronic)
IS  - 2093-596X (Linking)
VI  - 28
IP  - 4
DP  - 2013 Dec
TI  - Recurrent Insulin Autoimmune Syndrome Caused by alpha-Lipoic Acid in Type 2 Diabetes.
PG  - 326-30
LID - 10.3803/EnM.2013.28.4.326 [doi]
AB  - Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia 
      caused by insulin autoantibodies in the absence of exogenous insulin 
      administration. Some drugs containing sulfhydryl compounds are known to initiate 
      the onset of IAS. A 67-year-old female who had diabetes for 5 years visited the 
      outpatient clinic at our institution due to diabetic peripheral polyneuropathy. 
      She was prescribed alpha-lipoic acid (ALA), which contains two sulfur atoms. Two 
      weeks later, she complained of recurrent hypoglycemic symptoms. We detected a 
      high level of insulin and high titers of insulin autoantibodies. Her human 
      leukocyte antigen (HLA) genotype included the DRB1*0406 allele, which indicates a 
      high level of susceptibility to IAS. She was treated with prednisolone. After 
      this episode, she experienced two more hypoglycemic events after taking ALA for 
      diabetic neuropathy in other hospitals. As ALA can be used to treat diabetic 
      peripheral polyneuropathy, physician discretion is advised based on the 
      possibility of IAS due to ALA in diabetic patients.
FAU - Bae, Sang Mook
AU  - Bae SM
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Bae, Myoung Nam
AU  - Bae MN
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Kim, Eun Young
AU  - Kim EY
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Kim, Il Kyu
AU  - Kim IK
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Seo, Min Woo
AU  - Seo MW
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Shin, Jin Kyeong
AU  - Shin JK
AD  - Department of Internal Medicine, The Catholic University of Korea College of 
      Medicine, Seoul, Korea.
FAU - Cho, Sung Rae
AU  - Cho SR
AD  - Division of Endocrinology, Department of Internal Medicine, Changwon Fatima 
      Hospital, Changwon, Korea.
FAU - Jeong, Gui Hwa
AU  - Jeong GH
AD  - Division of Endocrinology, Department of Internal Medicine, Changwon Fatima 
      Hospital, Changwon, Korea.
LA  - eng
PT  - Journal Article
DEP - 20131212
PL  - Korea (South)
TA  - Endocrinol Metab (Seoul)
JT  - Endocrinology and metabolism (Seoul, Korea)
JID - 101554139
PMC - PMC3871037
OTO - NOTNLM
OT  - Alpha-lipoic acid
OT  - HLA-DRB1*0406 antigen
OT  - Insulin antibodies
OT  - Insulin autoimmune syndrome
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2014/01/08 06:00
MHDA- 2014/01/08 06:01
PMCR- 2013/12/01
CRDT- 2014/01/08 06:00
PHST- 2012/10/15 00:00 [received]
PHST- 2013/03/27 00:00 [accepted]
PHST- 2014/01/08 06:00 [entrez]
PHST- 2014/01/08 06:00 [pubmed]
PHST- 2014/01/08 06:01 [medline]
PHST- 2013/12/01 00:00 [pmc-release]
AID - 10.3803/EnM.2013.28.4.326 [doi]
PST - ppublish
SO  - Endocrinol Metab (Seoul). 2013 Dec;28(4):326-30. doi: 10.3803/EnM.2013.28.4.326. 
      Epub 2013 Dec 12.