外源性胰岛素自身免疫综合征六例诊治分析并文献复习

Diagnosis and therapy of six diabetic patients with insulin autoimmune syndrome induced by exogenous human insulin and related literature review

本文报道6例外源性胰岛素自身免疫综合征(EIAS)患者的临床特点,行5 h OGTT示血糖波动大,胰岛素和C-P浓度明显分离。3例用免疫印迹法测IAA阴性的血标本,外送用微量平板放射免疫法测IAA阳性。另3例用免疫印迹法测IAA阳性。通过文献复习,提高临床诊治率。不同检验方法影响IAA测定结果。糖尿病治疗过程中需要动态评估胰岛素应用的合理性。

The clinical features of exogenous insulin autoimmune syndrome（EIAS） in 6 diabetic patients were analyzed. The 5 h oral glucose tolerance test （OGTT） showed a high fluctuation of blood glucose （BG）, as well as C-peptide （C-P） and insulin separation. Negative results of insulin autoantibody （IAA） testing by western blot in three patients changed into positive when using radio immunity method. The other three patients had positive IAA results by western blot. Related literatures were also reviewed, in order to improve the ability of diagnosis and treatment of this disease. The result of the IAA was affected by testing method. Dynamically assessment the insulin application should be done during diabetes treatment.