反复发生低血糖的老年外源性胰岛素自身免疫综合征1例  

A case of exogenous insulin autoimmune syndrome in an elderly patient with recurrent hypoglycemia

作　　者：张汝轩 周新丽[1,2,3] ZHANG Ruxuan;ZHOU Xinli(Department of Endocrinology,Shandong Provincial Hospital,Shandong University,Key Laboratory of Endocrine Glucose&Lipids Metabolism and Brain Aging,Ministry of Education,Jinan 250021,China;Shandong Clinical Research Center of Diabetes and Metabolic Diseases,Jinan 250021,China;Shandong Institute of Endocrine and Metabolic Diseases,Jinan 250021,China)

机构地区：[1]山东大学,山东省立医院内分泌科,内分泌糖脂代谢与脑老化教育部重点实验室,山东济南250021 [2]山东省糖尿病与代谢疾病临床医学研究中心,山东济南250021 [3]山东省内分泌与代谢病研究所,山东济南250021

出　　处：《老年医学研究》2024年第6期63-66,共4页Geriatrics Research

摘　　要：通过回顾1例反复发生低血糖的老年糖尿病患者的诊治过程,以提高对外源性胰岛素自身免疫综合征的认识。本例患者实验室检测示胰岛素及C-肽增高,并出现分离现象;胰岛素自身抗体(IAA)及血清胰岛素细胞抗体(ICA)阳性;基因检测示CD3E基因点突变。推测其出现反复低血糖可能与其自身免疫特征、长期应用外源性胰岛素有关。To enhancethe understanding of exogenous insulin autoimmune syndrome,the diagnosis and treatment of an elderly diabetic patient with recurrent hypoglycemia were reviewd.Laboratory tests showed increased insulin and C-peptide with dissociation,positive insulin autoantibody(IAA)and serum islet cell antibody(ICA);and genetic testing showed a point mutation in the CD3E gene.It was hypothesized that the patient's recurrent hypoglycemia might be related to his autoimmune characteristics and long-term application of exogenous insulin.

关 键 词：低血糖 自身抗体 胰岛素 外源性胰岛素自身免疫综合征 CD3E基因 老年人 

分 类 号：R587.1[医药卫生—内分泌]