Details

Autor(en) / Beteiligte

• Galván, Raquel
• Fernández-Riejos, Patricia
• Sánchez Martínez, Pilar María
• Rodríguez-Chacón, Carmen
• Sánchez Mora, Catalina
• León-Justel, Antonio

Titel

Complete laboratory diagnosis of Insulin Autoimmune Syndrome

Ist Teil von

• Practical laboratory medicine, 2023-08, Vol.36, p.e00320, Article e00320

Ort / Verlag

Elsevier

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• The definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard or to confirm an analytical interference and diagnose a possible Insulin Autoimmune Syndrome we performed the following investigations: dilution linearity test, heterophilic antibody blocking, polyethylene glycol precipitation, measurements with alternative assays, and gel filtration chromatography by size exclusion. The latter technique confirmed that most of the insulin was complexed with a 150-kDa protein, corresponding to immunoglobulin G, identified as insulin autoantibodies. These antibodies were responsible for hypoglycemia attacks in the patient, who had a previous autoimmune disease. This case highlights the importance of carefully analyzing the results and ruling out possible interferences, as well as considering all kinds of pathologies, even if they are infrequent.