A case of type B insulin resistance syndrome treated with low-dose glucocorticoids
| العنوان: | A case of type B insulin resistance syndrome treated with low-dose glucocorticoids |
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| المؤلفون: | Tatsuhide Inoue, Naohisa Tamura, Masato Kotani, Issei Tanaka |
| المصدر: | Endocrinology, Diabetes & Metabolism Case Reports Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-5 (2019) |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Weight loss, Platelet count, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Red blood cell count, Diabetic nephropathy, Kidney, lcsh:Diseases of the endocrine glands. Clinical endocrinology, Betamethasone, Neutropaenia, chemistry.chemical_compound, 0302 clinical medicine, Japan, Voglibose, Insulin, Hyperglycaemia, Glucose (blood, fasting), Diuretics, biology, Diabetes, Immunosuppression, Proteinuria, Nephrology, 030220 oncology & carcinogenesis, Aspartate aminotransferase, Hyperglobulinaemia, Haematuria, Glucocorticoid, medicine.drug, Adult, medicine.medical_specialty, White blood cell count, Immunoglobulins, 030209 endocrinology & metabolism, Urinalysis, 03 medical and health sciences, BMI, Antinuclear antibody, Insulin resistance, Hyperinsulinaemia, Internal medicine, Diabetes mellitus, Glucosuria, Alkaline phosphatase, Angiotensin-converting enzyme inhibitors, Internal Medicine, medicine, Creatinine (serum), C-peptide (24-hour urine), Alpha-glucosidase inhibitors, Haemoglobin A1c, Glucocorticoids, Alanine aminotransferase, lcsh:RC648-665, business.industry, Asian - Japanese, Albumin, November, medicine.disease, Weight, Thrombocytopenia, Novel Treatment, Immunoglobulin A, Insulin receptor, Endocrinology, chemistry, Gamma-glutamyltranspeptidase, biology.protein, Autoimmune Disorders, Glycated hemoglobin, Insulin Resistance, business, Hypoglycaemia, Ketonuria, Anti-insulin receptor antibodies |
| الوصف: | Summary Type B insulin resistance syndrome is characterized by the presence of autoantibodies to the insulin receptor. We present a 57-year-old male admitted to a hospital due to body weight loss of 16 kg and hyperglycemia of 13.6 mmol/L. He was diagnosed with type B insulin resistance syndrome because the anti-insulin receptor antibodies were positive. We informed him that some hyperglycemic cases of this syndrome had been reported to be spontaneously remitted in 5 years, and he did not agree to be treated with high-dose glucocorticoids and/or immunosuppressive agents due to his concern for their adverse effects such as hyperglycemia and immunosuppression. He chose to be treated with insulin and voglibose, but fair glucose control could not be obtained. Six years later, he agreed to be treated with low-dose glucocorticoids practicable in outpatient settings. One milligram per day of betamethasone was tried orally and reduced gradually according to the values of glycated hemoglobin. After 30 months of glucocorticoid treatment, the anti-insulin receptor antibodies became undetectable and his fasting plasma glucose and glycated hemoglobin were normalized. This case suggests that low-dose glucocorticoids could be a choice to treat type B insulin resistance syndrome in outpatient settings. Learning points: Type B insulin resistance syndrome is an acquired autoimmune disease for insulin receptors. This case suggested the possibility of long-lasting, low-dose glucocorticoid therapy for the syndrome as an alternative for high-dose glucocorticoids or immunosuppressive agents. Since the prevalence of autoimmune nephritis is high in the syndrome, a delay of immunosuppressive therapy initiation might result in an exacerbation of nephropathy. |
| تدمد: | 2052-0573 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::34dcf221ba821c9c58aac189f98103cf https://pubmed.ncbi.nlm.nih.gov/31743096 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....34dcf221ba821c9c58aac189f98103cf |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20520573 |
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