胰岛素自身免疫综合征研究进展

Insulin autoimmune syndrome

胰岛素自身免疫综合征是引起自发性低血糖的重要原因之一,在日本是自发性低血糖症的第三大病因,多伴发自身免疫疾病,应用含巯基药物后诱发产生胰岛素自身抗体,患者常表现为反复性、严重自发性空腹或迟发性餐后低血糖,其低血糖发作时呈高胰岛素血症。停用诱发药物后,患者低血糖多可自行缓解。本文就胰岛素自身免疫综合征的发病机制、胰岛素自身抗体种类和来源、遗传易感因素、临床特点、诊断方法、诊断标准及治疗等方面的研究进展作一综述。

Insulin autoimmune syndrome is an important cause of spontaneous hypoglycemia as well as the third leading cause of spontaneous hypoglycemia in Japan. It is characterized by the production of insulin autoantibodies mostly induced by sulfur/sulfydryl containing drugs and is often complicated with autoimmune diseases. The patients have spontaneously recurrent and severe attack of fasting or late postprandial hypoglycemia accompanied by hyperinsulinemia, which would subside after drugs were discontinued. This paper reviews the research progress of the mechanism, type and source of insulin autoantibodies, genetic predisposing factors, clinical features, diagnostic methods, diagnostic standard and treatment of insulin autoimmune syndrome.