Insulin Autoimmune Syndrome Accompanied by Multiple Myeloma

Ito, Hiromitsu; Miyake, Tadashi; Nakashima, Kenichiro; Ito, Yuji; Tanahashi, Chisato; Uchigata, Yasuko

doi:10.2169/internalmedicine.55.6267

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…In terms of immune indexes, only the spleen index of group H14 significantly increased, and the concentrations of serum IgG and IgM in the high-dose groups were significantly higher than those in the other groups (Table 3). The increase of IgG and IgM boosts the immune response of the body, but may also have a partial negative effect on specific populations, such as patients with autoimmune diseases and multiple myeloma [50].…”

Section: Discussionmentioning

confidence: 99%

Polysaccharide from Patinopecten yessoensis Skirt Boosts Immune Response via Modulation of Gut Microbiota and Short-Chain Fatty Acids Metabolism in Mice

Qin

Cheng

et al. 2021

Foods

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Polysaccharide from marine shellfish has various bioactivities. In this study, the effects of polysaccharide from Patinopecten yessoensis skirt (PS) on boosting immune response in mice were evaluated, and the potential mechanisms were explored. The results showed that PS administration effectively increased the serum IgG and IgM levels, implying that PS had immune response-boosting properties. Moreover, PS administration could modulate the composition of the gut microbiota, and significantly improve short-chain fatty acids (SCFAs) metabolism, especially butyrate metabolism. Of note, the expression of the Tlr2, Tlr7, MyD88, Tnfa, and Il1b genes in toll-like receptor (TLR) signaling pathway was significantly increased. In summary, PS could boost immune response by modulating the gut microbiota and SCFAs metabolism correlating with the activation of the TLR signaling pathway. Therefore, PS can be developed as a special ingredient for functional product.

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Section: Discussionmentioning

confidence: 99%

Polysaccharide from Patinopecten yessoensis Skirt Boosts Immune Response via Modulation of Gut Microbiota and Short-Chain Fatty Acids Metabolism in Mice

Qin

Cheng

et al. 2021

Foods

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“…Apart from drugs, 12 cases were associated with haematological disorders like multiple myeloma/MGUS (cases 57, 76, 87, 88, 110, 128, 145, 260, 266 and 271), non‐Hodgkin B‐cell lymphoma (case 3) and myelodysplastic syndrome (case 69). The underlying mechanism is related to immune dyscrasias and autoantibody production …”

Section: Discussionmentioning

confidence: 99%

Management of Insulin Autoimmune Hypoglycaemia: Single‐centre experience from Western India with systematic review of world literature

Patel

Shah

Ramteke-Jadhav

et al. 2020

Clinical Endocrinology

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Background: Awareness about Insulin Autoimmune Hypoglycaemia (IAH) and its management remains limited. Methodology:We describe two cohorts: Cohort 1 (n = 7) included patients with IAH from a tertiary care centre in India and Cohort 2 (n = 294) included systematic review of published English literature from PubMed. They were compared with our insulinoma patients (n = 41). Results: Cohort 1 included seven female patients where two had drugs (carbimazole and thiocolchicoside) as triggering factors. Except for one patient requiring oral prednisolone, others had spontaneous remission. The unique features from our series are being first case series of IAH from India and reporting of second case of thiocolchicoside triggered IAH.Cohort 2 had 294 patients identified from 149 publications. Mean age was 54 ± 19 years. Thirty-five different triggers were identified from 160 cases.Antithyroid drugs were most common triggers in Japanese patients and most common HLA allele was DRB1*0406, while it was alpha-lipoic acid and HLA DRB1*0403 in non-Asians. Serum Insulin >100 µIU/mL and insulin to C-peptide molar ratio (ICMR) >0.25 had specificity of 100% and 97.5%, respectively, for IAH as compared to insulinoma. 56% patients had remission with complex carbohydrate diet and trigger removal while 43% required immunosuppressants. 70% achieved remission within 6 months. Conclusions:Middle age remains most common age group. Sulfhydryl drugs are most common triggers. Serum Insulin >100 µIU/mL and ICMR > 0.25 in critical sample are good predictors for diagnosis of IAH, which needs to be confirmed by IAA.Conservative management with dietary modification and trigger removal usually suffices in majority. Rests need immunosuppressants. K E Y W O R D Scase series of IAH, insulin auto-antibodies, insulin autoimmune hypoglycaemia, insulin autoimmune syndrome, management of IAH, systematic review of IAH

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“…Approximately 80% of IAS cases coexist with other autoimmune diseases, namely, most patients with Graves' disease [ 7 ] and others with systemic lupus erythematosus [ 8 ], rheumatoid arthritis, chronic hepatitis. Other less common coexisting diseases include ankylosing spondylitis [ 9 ], antineutrophil cytoplasmic antibody-associated glomerulonephritis, alcoholic cirrhosis, polymyositis and systemic sclerosis, psoriasis [ 10 ], multiple myeloma [ 11 , 12 ], and monoclonal gammopathy [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Insulin Autoimmune Syndrome: A Systematic Review

Lin

Chen

Ning

2023

International Journal of Endocrinology

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Insulin autoimmune syndrome (IAS) is a rare endocrine disorder characterized by recurrent episodes of severe hypoglycemia, markedly elevated serum insulin, and positive insulin autoantibodies. In recent years, various countries have reported it one after another. It can be seen that we must pay attention to this disease. The diagnosis of IAS is challenging, requiring a careful workup aimed at excluding other causes of hyperinsulinemic hypoglycemia. High levels of insulin autoantibodies are found in patients, and C-peptide is not parallel to insulin, which could be diagnostic. IAS is a self-limiting disease with a good prognosis. Its treatment mainly includes symptomatic supportive treatment, such as adjusting the diet and using acarbose and other drugs to delay the absorption of glucose to prevent hypoglycemia. For patients with severe symptoms, available treatments may include drugs that reduce pancreatic insulin secretion (such as somatostatin and diazoxide), immunosuppressants (glucocorticoids, zaprin, and rituximab), and even plasma exchange to remove autoantibodies from the body. This review provides a comprehensive analysis of the epidemiology, pathogenesis, clinical manifestations, diagnosis and identification, and monitoring and treatment management of IAS.

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Insulin Autoimmune Syndrome Accompanied by Multiple Myeloma

Cited by 8 publications

References 13 publications

Polysaccharide from Patinopecten yessoensis Skirt Boosts Immune Response via Modulation of Gut Microbiota and Short-Chain Fatty Acids Metabolism in Mice

Polysaccharide from Patinopecten yessoensis Skirt Boosts Immune Response via Modulation of Gut Microbiota and Short-Chain Fatty Acids Metabolism in Mice

Management of Insulin Autoimmune Hypoglycaemia: Single‐centre experience from Western India with systematic review of world literature

Insulin Autoimmune Syndrome: A Systematic Review

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