Characterization of insulin autoantibodies in a patient with autoimmune hypoglycemia

J Endocrinol Invest. 1995 Apr;18(4):299-304. doi: 10.1007/BF03347817.

Abstract

A 60-year-old man referred because of hypoglycemic bouts was found to have insulin autoantibodies. Total plasma insulin was as high as 1.44 nmol/l. Both plasma free insulin and C-peptide were in the normal range. The indirect immunofluorescence technique showed positivity for antinuclear antibodies. The T-lymphocyte populations in the peripheral blood were normal. When serum binding capacity for pork insulin was measured, antibodies binding pork insulin were not detected. The patient's serum bound 125I-insulin. The binding protein was identified to be an immunoglobulin G. The kinetics of dissociation, studied by the Scatchard analysis of the autoantibody, showed a curvilinear plot, which was analyzed in two components. Cold human insulin was able to compete with 125I-insulin for the antibody binding site (I.C.50 = 1.35 nmol/ml). These antibodies were apparently not associated with antibodies directed against the insulin receptor.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / immunology*
  • Autoantibodies / metabolism*
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / metabolism
  • Blood Proteins / metabolism
  • Cells, Cultured
  • Humans
  • Hypoglycemia / complications
  • Hypoglycemia / immunology*
  • Hypoglycemia / metabolism
  • Immunoglobulin G / biosynthesis
  • Immunoglobulin G / metabolism
  • Insulin Antibodies / immunology*
  • Insulin Antibodies / metabolism
  • Male
  • Middle Aged
  • Protein Binding
  • Receptor, Insulin / immunology

Substances

  • Autoantibodies
  • Blood Proteins
  • Immunoglobulin G
  • Insulin Antibodies
  • Receptor, Insulin