α-Lipoic Acid and Insulin Autoimmune Syndrome

Ishida, Yukinori; Ohara, Takeshi; Okuno, Yoko; Itö, Tatsuo; Hirota, Yushi; Furukawa, Katsunori; Sakaguchi, Kazuhiko; Ogawa, Wataru; Kasuga, Masato

doi:10.2337/dc07-0689

Cited by 29 publications

(18 citation statements)

References 13 publications

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“…thiols with -SH) such as methimazole, captopril, D-penicillamine, hydralazine, glutathione, methionine, mercaptans, clopidogrel, aurothioglucose, imipenem, penicillin G and diltiazem [19][20][21] were deemed to have the potential to trigger IAS. An additional drug namely α-lipoic acid (ALA) which also contains sulfur (cyclic disulfide) was also reported to cause IAS in Japanese [19]; this was quickly followed by numerous reports in patients all of whom were also Japanese [21][22][23][24][25][26]. The first case in a Caucasian (Italian) appeared in Sicily in 2011 [27]; however, within 22 months, six more cases were also identified by the same medical centre in Sicily [28].…”

Section: Introductionmentioning

confidence: 97%

The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis

Ismail¹

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Insulin autoimmune syndrome (IAS) is considered to be very rare in Caucasians. Understanding its pathophysiology is paramount in (a) appreciating its potential impact on analyses of pancreatic hormones and (b) explaining its highly variable clinical manifestations in non-diabetic, non-acutely ill patients with indeterminate hypoglycaemia. The underlying aetiology of IAS is the presence of variable affinity/avidity endogenous insulin antibodies in significant amounts. The two types of insulin antibodies namely antibodies which bind insulin and/ or proinsulin(s) and receptor antibodies (insulin mimetic) will be discussed. Their biochemical and immunological roles in causing hypoglycaemia will be highlighted. Clinical manifestations of IAS can vary from mild and transient to spontaneous, severe and protracted hypoglycaemia necessitating in extreme cases plasmapheresis for glycaemic control. Antibodies of IAS can interfere in pancreatic immunoassay tests causing erroneous and potentially misleading results. Thorough testing for endogenous insulin antibodies must be considered in the investigations of non-diabetic, non-acutely ill patients with indeterminate and/or unexplained hypoglycaemia.Keywords: endogenous insulin antibodies; Hirata's disease, insulin autoimmune hypoglycaemia; hypoglycaemia in non-diabetic; insulin autoimmune syndrome (IAS); interference in immunoassays of insulin, proinsulin and C-peptide; wrong immunoassay results .

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Section: Introductionmentioning

confidence: 97%

The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis

Ismail¹

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…It is well known that insulin autoantibody is produced by the use of drugs containing the SH group1, 2, 3. In addition, it has recently been shown that albumin has cysteine residue (Cys34), of which the reducing capacity is strong, and that albumin has anti‐oxidant effects, as observed with α−lipoic acid5.…”

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confidence: 99%

Human serum albumin: Possible cause of insulin autoimmune syndrome

Kamei

Kaneto

Shigemoto

et al. 2016

J of Diabetes Invest

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“…Likely due to the increased usage of LA by the general population of Japan, along with a heightened awareness of IAS, there have been an increasing number of cases in Japan associated with LA use. Since the first case in Japan was reported in 2003, seventeen cases of LA‐related IAS have now been reported . The great majority of cases are associated with the HLA‐DRB1*04:06 allele, with only a few cases being associated with HLA‐DRB1*04:03.…”

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confidence: 99%

“…Since the first case in Japan was reported in 2003, seventeen cases of LA-related IAS have now been reported. 10,12,17,[26][27][28] The great majority of cases are associated with the HLA-DRB1*04:06 allele, with only a few cases being associated with HLA-DRB1*04:03. Outside of Japan, only one case of LA-related IAS has been described in a European.…”

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confidence: 99%