Monoclonal Insulin Autoimmune Syndrome Successfully Treated With Plasma Cell Directed Therapy.

Autor: Askeland FB; Department of Haematology, Oslo Myeloma Center, Oslo University Hospital, Nydalen, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Blindern, Oslo, Norway. Electronic address: friask@ous-hf.no., Frøen HM; Department of Haematology, Oslo Myeloma Center, Oslo University Hospital, Nydalen, Oslo, Norway., Bolstad N; Department of Medical Biochemistry, Oslo University Hospital, Nydalen, Oslo, Norway., Thorsby PM; Department of Medical Biochemistry, Oslo University Hospital, Nydalen, Oslo, Norway; Hormone Laboratory, Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Nydalen, Oslo, Norway., Schjesvold F; Department of Haematology, Oslo Myeloma Center, Oslo University Hospital, Nydalen, Oslo, Norway., Wammer ACP; Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway., Følling I; Institute of Clinical Medicine, University of Oslo, Blindern, Oslo, Norway; Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway., Tjønnfjord GE; Department of Haematology, Oslo Myeloma Center, Oslo University Hospital, Nydalen, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Blindern, Oslo, Norway. Electronic address: gtjonnfj@ous-hf.no.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2024 Oct 11. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1016/j.clml.2024.10.005
Abstrakt: Background: Monoclonal insulin autoimmune syndrome (IAS) is a very rare disease characterized by severe attacks of hypoglycemia caused by circulating anti-insulin antibodies produced by a B-cell clone, usually clonal plasma cells.
Method: We present 2 female Norwegian patients with monoclonal IAS. The anti-insulin antibodies were quantified by immune precipitation and characterized using a 3-step manual in-house assay. Both patients received plasma cell directed therapy.
Result: The first patient received plasma cell directed therapy for a time-limited period and achieved a sustained clinical remission without detectable anti-insulin antibodies. The second patient receives continuous plasma cell directed therapy and is in clinical remission with low values of detectable anti-insulin antibodies.
Conclusion: Plasma cell directed therapy was effective and safe in our 2 cases of monoclonal IAS. We recommend considering plasma cell directed therapy for these patients.
Competing Interests: Disclosure Frida Bugge Askeland has received consulting fees from Janssen, Sanofi and Amgen, honoraria/payment from Janssen and Sanofi and participated in advisory boards for Janssen and Sanofi. Hege M. Frøen has no conflict of interest Nils Bolstad has no conflict of interest Per Medbøe Thorsby has received consulting fees from Antidoping Norway. Fredrik Schjesvold has received grants from Targovax, consulting fees from GSK, BMS, Oncopeptides, XNK Therapeutics, Takeda, Janssen, Sanofi and Galapagos, honoraria/payment from Amgen, BMS, Takeda, Sanofi, Menarini, AbbVie, Janssen, Oncopeptides and GSK and participated in advisory boards for AbbVie, Janssen, Regeneron and Sanofi. Anne Cathrine Parelius Wammer has received consulting fees from Novo Nordisk, honoraria/payment from Novo Nordisk, Sanofi and Buehringer and participated in advisory boards for Novo Nordisk. Ivar Følling has no conflict of interest. Geir E. Tjønnfjord has no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE