A case of insulin autoimmune syndrome after tuberculosis treatment

Abstract

The subject was an 81-year-old male. He visited his local general hospital upon becoming aware of dryness of the mouth, perspiration, palpitations, and anarthria literalis while driving. Although these symptoms disappeared when he visited our department, he was hypoglycemic with a blood glucose level of 53 mg/dL from time to time. Therefore, he was referred to our department for scrutiny and treatment. With no usage history of insulin, he had hyperinsulinemia (1629 μ U/mL) and HLA-DR4, in addition to being positive for insulin antibodies. He was diagnosed with insulin autoimmune syndrome (IAS). Although this patient had no history of the oral administration of drugs with an SH base, such as thiamazole and alpha lipoic acid, which are thought to be associated with the onset of IAS, he had been diagnosed with pulmonary tuberculosis at 78 years old and underwent multi-drug therapy using antituberculosis agents including isoniazid. This may affect the onset of IAS.