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Lupus. 2017 Jan;26(1):95-97. Epub 2016 Jul 14.

A systemic lupus erythematosus patient presenting as type B insulin resistance complicated with cryoglobulinemia.

Author information

1
Department of Gastroenterology, Peking University People's Hospital, Beijing, China.
2
Department of Nephrology, Peking University People's Hospital, Beijing, China yanmail10004@163.com.
3
Department of Nephrology, Peking University People's Hospital, Beijing, China.

Abstract

Systemic lupus erythematosus (SLE) patients may present with various symptoms and multisystem damage. We reported a 63-year-old male patient with SLE presenting as type B insulin resistance (TBIR) complicated with cryoglobulinemia. TBIR is an extremely rare disease, which is a manifestation of anti-insulin receptor antibodies (AIRA). Clinical feature is a sudden onset of hyperglycemia with major weight loss; however, the ensuing refractory hypoglycemia is more fatal. The average dosage of exogenous insulin is 5100 U/d. SLE patients with AIRA had poor prognosis, most of whom died of SLE activity. Cryoglobulins are immunoglobulins that reversibly precipitate in the cold, which will induce clinical symptoms. Non-infectious mixed cryoglobulinemia is frequently secondary to autoimmune diseases, such as SLE. Our patient was prescribed methylprednisolone (MP) and cyclophosphamide (CTX). Finally he had remission during the short-term follow-up. To our knowledge, this is the first case report of an SLE patient presenting as TBIR complicated with cryoglobulinemia.

KEYWORDS:

Systemic lupus erythematosus (SLE); cryoglobulinemia; type B insulin resistance (TBIR)

PMID:
27416845
DOI:
10.1177/0961203316655209
[Indexed for MEDLINE]

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