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Title: A clinical case of insulin autoimmune syndrome with monoclonal gammopathy of uncertain significance; complexity in management
Authors: Clifford, Liam ;Joseph, Flavian ;Joshi, Tripti 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Jun-2024
Source: 2024(6):omae054
Journal title: Oxford Medical Case Reports
Department: Endocrinology
Abstract: Insulin autoimmune syndrome (IAS) is a rare cause of spontaneous hypoglycaemia. We discuss a 91-year-old Caucasian lady who presented with syncope and episodic adrenergic and neuroglycopenic symptoms. Despite significantly elevated insulin, C-peptide, and proinsulin levels with the presence of anti-insulin antibodies, a pancreatic mass was not identified. Serum immunoelectrophoresis demonstrated monoclonal gammopathy of undetermined significance (MGUS). Treatment involved high-dose steroids, diazoxide, corn starch and acarbose, however the patient passed away four months later due to worsening co-morbidities. The management of IAS in the setting of MGUS is challenging.
DOI: 10.1093/omcr/omae054
ISSN: 2053-8855
Publicaton type: Journal Article
Keywords: Endocrinology
Appears in Collections:Health Service Research

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