Insulin autoimmune syndrome caused by an adhesive skin patch containing loxoprofen-sodium

Intern Med. 2013;52(21):2447-51. doi: 10.2169/internalmedicine.52.0570.

Abstract

A 62-year-old woman complained of repeated hypoglycemic events. A 75 g oral glucose tolerance test (75 gOGTT) showed a marked increase in the plasma insulin level and impaired glucose tolerance. The patient exhibited a high titer of plasma anti-insulin autoantibodies. Her diagnosis was insulin autoimmune syndrome (IAS). Following the cessation of loxoprofen-sodium (LOXs), she experienced no further hypoglycemic episodes. However, the hypoglycemic attacks recurred following the accidental readministration of LOXs in an adhesive skin patch. Considering the changes in the titer of anti-insulin autoantibodies, the repeated 75 gOGTT and the repeated Scatchard analysis, we determined LOXs to be the cause of the IAS and evaluated the characteristics of the autoantibodies.

Publication types

  • Case Reports

MeSH terms

  • Administration, Cutaneous
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / immunology
  • Autoantibodies / blood
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / etiology*
  • Autoimmune Diseases / immunology
  • Blood Glucose / metabolism
  • Female
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / etiology
  • Hypoglycemia / immunology
  • Insulin / blood
  • Insulin / immunology
  • Insulin Antibodies / blood*
  • Middle Aged
  • Phenylpropionates / administration & dosage
  • Phenylpropionates / adverse effects*
  • Phenylpropionates / immunology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Autoantibodies
  • Blood Glucose
  • Insulin
  • Insulin Antibodies
  • Phenylpropionates
  • loxoprofen