Rituximab for the treatment of type B insulin resistance syndrome: a case report and review of the literature
| Autor: | Masayuki Iyoda, Takako Inokuchi, Tsutomu Hirano, Yasuto Shikida, Ken Iseri, Tomoki Morikawa, Takanori Shibata, Noriko Hara |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Endocrinology Diabetes and Metabolism medicine.medical_treatment 030204 cardiovascular system & hematology Autoimmune Diseases Diabetic nephropathy 03 medical and health sciences 0302 clinical medicine Endocrinology Insulin resistance Internal Medicine medicine Humans 030212 general & internal medicine Adverse effect Metabolic Syndrome business.industry Insulin Middle Aged medicine.disease Thrombocytopenic purpura Immunology Rituximab Insulin Resistance business Vasculitis Rare disease medicine.drug |
| Zdroj: | Diabetic Medicine. 34:1788-1791 |
| ISSN: | 0742-3071 |
| DOI: | 10.1111/dme.13524 |
| Popis: | Background Type B insulin resistance syndrome is a rare disease characterized by refractory transient hyperglycaemia and severe insulin resistance associated with circulating anti-insulin receptor antibodies. A standardized treatment regimen for type B insulin resistance syndrome has yet to be established. Case report We report the case of a 64-year-old man undergoing haemodialysis for antineutrophil cytoplasmic antibody-associated vasculitis and diabetic nephropathy, who developed rapid onset of hyperglycaemia (glycated albumin 52.1%). Type B insulin resistance syndrome was diagnosed, on the basis of positivity for anti-insulin receptor antibodies and the man's autoimmune history of antineutrophil cytoplasmic antibody-associated vasculitis and idiopathic thrombocytopenic purpura. Although severe hyperglycaemia persisted in spite of corticosteroids and high-dose insulin therapy, rituximab treatment resulted in remarkable improvement of the man's severe insulin resistance and disappearance of anti-insulin receptor antibodies without any adverse effects. Conclusions According to a literature review of 11 cases in addition to the present case, rituximab appears to be a safe and effective strategy for the treatment of corticosteroid-resistant type B insulin resistance syndrome. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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