Marked hyperglycaemia (30.9 mmol l −1 ) during interferon-␥ (IFN-␥) therapy for asymptomatic recurrent renal cancer as multiple lung metastases in a 52-year-old man is described. Although the involvement of IFN-␥ has been reported in the development of autoimmune diabetes, in this case, antibodies against pancreatic -cells including anti-islet cell antibody (ICA) and anti-glutamic acid decarboxylase (GAD) antibody were negative. Moreover, serum level of immunoreactive insulin (IRI) (11 U ml −1 at fasting) and urinary excretion of C-peptide (108 g day −1 , reference range: 20-130) suggested insulin resistance, supported by results of insulin tolerance tests. With insulin therapy and cessation of IFN-␥, fasting blood glucose concentration returned to 6.2 mmol l −1 , and insulin therapy was discontinued. The injection of IFN-␥ may cause hyperglycaemia because of insulin resistance, rather than -cell injury.
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