Insulin Autoimmune Syndrome Caused by an Adhesive Skin Patch Containing Loxoprofen-Sodium

• Published in: Internal Medicine Vol. 52; no. 21; pp. 2447 - 2451
• Main Authors: Okazaki-Sakai, Satoko, Yoshimoto, Sachiko, Yagi, Kunimasa, Wakasugi, Takanobu, Takeda, Yoshiyu, Yamagishi, Masakazu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2013
• Subjects: 75g oral glucose tolerance test; adhesive skin patch; 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; insulin autoimmune syndrome; loxoprofen-sodium; Middle Aged; Phenylpropionates - administration & dosage; Phenylpropionates - adverse effects; Phenylpropionates - immunology; Scatchard analysis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.52.0570

A 62-year-old woman complained of repeated hypoglycemic events. A 75g oral glucose tolerance test (75gOGTT) 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 75gOGTT and the repeated Scatchard analysis, we determined LOXs to be the cause of the IAS and evaluated the characteristics of the autoantibodies.