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Case Reports in Endocrinology
Volume 2017 (2017), Article ID 6423852, 3 pages
https://doi.org/10.1155/2017/6423852
Case Report

Rare Cause of Recurrent Hypoglycemia: Insulin Autoimmune Syndrome

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence should be addressed to Apiradee Sriwijitkamol; moc.liamtoh@99iseedaripa

Received 19 July 2017; Accepted 18 September 2017; Published 26 November 2017

Academic Editor: Lucy Mastrandrea

Copyright © 2017 Rungsima Tinmanee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a case of insulin autoimmune syndrome associated with several autoantibodies, presenting with recurrent hypoglycemia, predominantly in the postprandial period, which improved by dietary management and spontaneously resolved within two months. Differentiation from other causes of hyperinsulinemic hypoglycemia, such as insulinoma, is important to avoid unnecessary invasive procedures or surgical interventions. The 75-gram oral glucose tolerance test (OGTT) and mixed meal test showed a typical pattern, which may be useful indirect evidence of insulin autoimmune syndrome.