A Case of Autoimmune Hypoglycemia in a Newly Diagnosed HIV Patient / 대한내과학회지

ABSTRACT

Autoimmune hypoglycemia is a rare cause of hypoglycemia, characterized by insulin autoantibodies, hyperinsulinemia, and fasting hypoglycemia without previous insulin immunization. This paper reports autoimmune hypoglycemia in a patient with a newly diagnosed HIV infection. A 63-year-old female visited the emergency room because of decreased mentality with a low blood glucose and high plasma insulin concentration. There was no evidence of insulinoma and the anti-insulin antibody was positive at 92.42%, so she was diagnosed with autoimmune hypoglycemia. She also had positive human immunodeficiency virus (HIV) antibody tests, and the CD4-positive T cell count was 28/microL. Therefore, a diagnosis of acquired immunodeficiency syndrome (AIDS) was confirmed and she was started on highly active antiretroviral therapy (HAART). The prednisolone therapy for the autoimmune hypoglycemia was held. Subsequently, she has maintained a stable plasma glucose level without dextrose. The recovery from hypoglycemia may reflect the disease course of the autoimmune hypoglycemia, or be the effect of a protease inhibitor.