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本文报道1例胰岛素自身免疫综合征及有关的文献。患者为49岁男性病人,曾因弥漫性甲状腺肿接受1个月的他巴唑治疗,无糖尿病及低血糖发作史,以往从未注射过胰岛素。于1984年8月12日晨10时出现严重低血糖昏迷、癫痫样发作,血糖16mg/dl,静脉注射葡萄糖后好转,实验室检查示空腹低血糖、糖耐量减退和餐后尿糖、血清中检得大量胰岛素抗体,应用PEG处理后的血浆胰岛素测定示有空腹高胰岛素血症,于葡萄糖负荷后无胰岛素高峰,免疫学检查发现有抗胰岛素抗体、抗TSH受体抗体、抗甲状腺微粒体抗体和抗垂体细胞抗体。1个月后空腹低血糖消失,糖耐量恢复正常、胰岛素抗体值明显降低。
This article reports a case of insulin autoimmune syndrome and related literature. The patient, a 49-year-old male patient, received a 1-month course of methimazole therapy for diffuse goitre without diabetes and a history of hypoglycemia and had never injected insulin in the past. Serious hypoglycemic coma, epileptic seizures, blood glucose 16 mg / dl at 10 am on August 12, 1984, improved after intravenous glucose administration, laboratory tests showed fasting hypoglycemia, impaired glucose tolerance and postprandial urine glucose, A large number of insulin antibodies were detected. The plasma insulin test after PEG treatment showed fasting hyperinsulinemia and no insulin peak after glucose loading. Anti-insulin antibody, anti-TSH receptor antibody, anti-thyroid microsomal antibody And anti-pituitary antibody. Fasting hypoglycemia disappeared after 1 month, glucose tolerance returned to normal, insulin antibody value was significantly reduced.