Glucagon Binding Autoantibodies in a Patient with Hyperthyroidism Treated with Methimazole*

Abstract

A 47-yr-old woman who had previously received methimazole (MMI) treatment for hyperthyroidism was found to have glucagon binding autoantibodies in plasma. She had never received glucagon. The binding substances were detected in plasma at the time of a glucagon RIA. [125I]Glucagon binding was inhibited only by porcine glucagon and porcine glicentin, and dissociated at acid pH. The substances proved to be glucagon binding antibodies (immunoglobulin G, L-chain K-type), as determined by ammonium sulfate and radioprecipitation. There were no clinical manifestations related the presence of these autoantibodies. In a survey of 91 patients with thyroid disease, 3 patients whose plasma bound [125I]glucagon were identified among 41 with hyperthyroidism who were receiving MMI treatment. Such binding was not found in plasma from untreated hyperthyroid patients, those receiving propylthiouracil or those with chronic thyroiditis. These findings suggest that the development of glucagon antibodies in hyperthyroidism may be associated with MMI treatment.

Autoantibodies to Insulin Are Present in Sera of Patients With Autoimmune Thyroid Disease

“…Moreover, there have also been reports of spontaneous hypoglycemia in patients with hypothyroidism or Graves' disease (14,15). Hirata et al (14) described a patient with Graves' disease who had severe episodes of hypoglycemia, elevated serum insulin levels (up to 35,280 fxU/ml), and the presence of insulin-binding antibodies.…”

Macroprolactinemia: Diagnostic, Clinical, and Pathogenic Significance

“…There are reportedly several autoantibodies against hormones other than PRL: insulin [6], glucagon [7], thyroid hormone [8], parathyroid hormone [9], anterior pituitary hormones such as adrenocorticotropic hormone (ACTH) [10], luteinizing hormone (LH), follicle stimulating hormone (FSH) [11], growth hormone (GH) [12] and thyroid stimulating hormone (TSH) [13], and posterior pituitary hormones such as vasopressin and oxytocin [14]. This paper focuses on the diagnostic, clinical, and pathogenic features of macroprolactinemia.…”

Goodpasture’s Syndrome in a Patient Receiving Penicillamine and Carbimazole

“…Carbimazole, like penicillamine, has an active sulphydryl group, and it exhibited an adverse-effect profile similar to that of penicillamine. Vasculitis, a lupus-like syn drome, nephrotic syndrome, and finally the spontaneous appearance of circulating antibodies to neutrophils, in sulin or glucagon have been described in association with methimazole use [23][24][25][26][27][28]. Although these reactions usually occur within weeks of initiation of therapy, they have also developed after many months or even years of uncomplicated treatment.…”