Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0409974 (lupus)
 22,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 47-year-old man with Graves' disease suffered from a feeling of hunger and sweating in the night, polyarthralgia and fever one month after the start of treatment with methimazole. The above symptoms were ascribed to the side effects of methimazole; insulin autoimmune syndrome and lupus-like syndrome. The change in the antithyroid drug to propylthiouracil caused an amelioration of the symptoms. In addition to an anti-insulin antibody with a high binding capacity, hyperglucagonemia (260 pg/ml with a plasma glucose level of 61 mg/dl) was observed, which returned to normal in parallel with the decrease in the insulin binding capacity of the plasma one month after beginning the treatment with propylthiouracil. A normal decrease in the plasma glucagon level due to exogenous insulin (2 mU/kg/min) was observed with the euglycemic clamp. However, the plasma glucagon level was not suppressed by the oral glucose loading and elicited a poor response to the arginine infusion. Taking previous reports into account, this basal hyperglucagonemia seems to be a characteristic finding in the insulin autoimmune syndrome, while a sluggish response of glucagon to oral glucose or arginine infusion might be ascribed to hyperthyroidism. This is the first case report concerning a kinetical study of the glucagon secretion in insulin autoimmune syndrome with Graves' disease.
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PMID:Hyperglucagonemia of insulin autoimmune syndrome induced by methimazole in a patient with Graves' disease. 265 8

A 37-year-old man presented with sweating, confusion, palpitations, hunger and tremor of 3 months duration. The symptoms disappeared after ingestion of food. After 3 months, he suffered from irregular fever, arthritis, rash, photosensitivity, and was admitted to the hospital. His antinuclear antibody, anti-double stranded DNA antibody, anti-smith antibody and lupus erythematosus cell phenomenon were all positive. Urine analysis showed albuminuria; his 24-h urine protein was 4.7 g. During hospitalisation, the patient presented with loss of consciousness three times because of hypoglycaemia. His serum insulin level during the hypoglycaemic episode was high at 490-1080 mmol/L (normal range: 6.00-27.00 mmol/L). He had never received an insulin rejection. Both insulin autoantibody and insulin receptor antibody were positive. Investigations confirmed systemic lupus erythematosus (SLE) with autoimmune hypoglycaemia. High-dose of corticosteroids, chloroquine and cyclophosphamide therapy had resulted in remission of hypoglycaemia associated with resolution of circulating antibodies to insulin and insulin receptor, and improvement in clinical and laboratory features of SLE.
Lupus 2009 Apr
PMID:Systemic lupus erythematosus presenting as hypoglycaemia with insulin receptor antibodies and insulin autoantibodies. 1931 1