Brief report: Hypoglycemia due to a monoclonal insulin-binding antibody in multiple myeloma

Bruce B Redmon, Kathryn L. Pyzdrowski, Michael K. Elson, Neil E. Kay, Agustin P. Dalmasso, frank q Nuttall

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

RECURRENT, severe hypoglycemia in the absence of exogenous insulin administration is uncommon. Reported causes include islet-cell adenomas or carcinomas, surreptitious use of insulin or sulfonylurea medications, stimulatory insulin-receptor antibodies, and various non—islet-cell tumors.1 2 3 4 The autoimmune insulin syndrome is another rare cause of hypoglycemia.5 , 6 This syndrome is characterized by late postprandial hypoglycemia and the presence of polyclonal insulin-binding autoantibodies, typically occurring in a patient with other autoimmune disease. Excess insulin is released in response to a meal because of binding to antibodies. Later, as the bound insulin is released, it causes hypoglycemia. We describe a patient who presented with a hypoglycemic.

Original languageEnglish (US)
Pages (from-to)994-998
Number of pages5
JournalNew England Journal of Medicine
Volume326
Issue number15
DOIs
StatePublished - Apr 9 1992

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