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Severe insulin-resistant diabetes due to insulin antibodies associated with eosinophilia

Takaya, Makiyo; Nagao, Mototsugu LU ; Takemitsu, Shuji; Nakajima, Yasushi; Sugihara, Hitoshi; Uchigata, Yasuko and Oikawa, Shinichi (2015) In JAMA Internal Medicine 54(18). p.2367-2371
Abstract

A 66-year-old man with type 2 diabetes on hemodialysis treatment was admitted due to poor glycemic control. His serum insulin level and the 125I-insulin binding rate were extremely high with an increased eosinophil count, although he did not have an allergic reaction to insulin or an elevation of specific IgE for human insulin. A Scatchard analysis revealed that the patient’s insulin antibodies had a low affinity constant and a high binding capacity. Prednisolone administration decreased the eosinophil count and 125I-insulin binding rate; accordingly, the glycemic control improved. Corticosteroid therapy may be a potent therapeutic strategy for insulin antibody-induced severe insulin resistance with... (More)

A 66-year-old man with type 2 diabetes on hemodialysis treatment was admitted due to poor glycemic control. His serum insulin level and the 125I-insulin binding rate were extremely high with an increased eosinophil count, although he did not have an allergic reaction to insulin or an elevation of specific IgE for human insulin. A Scatchard analysis revealed that the patient’s insulin antibodies had a low affinity constant and a high binding capacity. Prednisolone administration decreased the eosinophil count and 125I-insulin binding rate; accordingly, the glycemic control improved. Corticosteroid therapy may be a potent therapeutic strategy for insulin antibody-induced severe insulin resistance with eosinophilia.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Corticosteroids, Eosinophilia, Insulin antibodies
in
JAMA Internal Medicine
volume
54
issue
18
pages
2367 - 2371
publisher
American Medical Association
external identifiers
  • scopus:84941557416
ISSN
0918-2918
DOI
10.2169/internalmedicine.54.4022
language
English
LU publication?
no
id
88d04f91-cb06-4ccb-9d87-b497c1e025fb
date added to LUP
2017-08-23 20:01:07
date last changed
2017-08-27 06:46:34
@article{88d04f91-cb06-4ccb-9d87-b497c1e025fb,
  abstract     = {<p>A 66-year-old man with type 2 diabetes on hemodialysis treatment was admitted due to poor glycemic control. His serum insulin level and the <sup>125</sup>I-insulin binding rate were extremely high with an increased eosinophil count, although he did not have an allergic reaction to insulin or an elevation of specific IgE for human insulin. A Scatchard analysis revealed that the patient’s insulin antibodies had a low affinity constant and a high binding capacity. Prednisolone administration decreased the eosinophil count and <sup>125</sup>I-insulin binding rate; accordingly, the glycemic control improved. Corticosteroid therapy may be a potent therapeutic strategy for insulin antibody-induced severe insulin resistance with eosinophilia.</p>},
  author       = {Takaya, Makiyo and Nagao, Mototsugu and Takemitsu, Shuji and Nakajima, Yasushi and Sugihara, Hitoshi and Uchigata, Yasuko and Oikawa, Shinichi},
  issn         = {0918-2918},
  keyword      = {Corticosteroids,Eosinophilia,Insulin antibodies},
  language     = {eng},
  month        = {09},
  number       = {18},
  pages        = {2367--2371},
  publisher    = {American Medical Association},
  series       = {JAMA Internal Medicine},
  title        = {Severe insulin-resistant diabetes due to insulin antibodies associated with eosinophilia},
  url          = {http://dx.doi.org/10.2169/internalmedicine.54.4022},
  volume       = {54},
  year         = {2015},
}