ArticleThe Journal of clinical endocrinology and metabolism2015
Successful treatment of type B insulin resistance with rituximab.
Article in The Journal of clinical endocrinology and metabolism, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Type B insulin resistance syndrome: a systematic review.Archives of endocrinology and metabolism · 2020Pooled it
- Combined Immunosuppressive Therapy Induces Remission in Patients With Severe Type B Insulin Resistance: A Prospective Cohort Study.Diabetes care · 2018Trial
- Alpha-lipoic acid as a trigger of insulin autoimmune syndrome: Current evidence, a case-based approach, diagnostic pitfalls, and practical management.Metabolism open · 2026Review
- Long-term remission of type B insulin resistance syndrome with immunotherapy: A case report.Journal of diabetes investigation · 2026Article
- Type B insulin resistance with glycemic extremes: a case report and literature review.Frontiers in endocrinology · 2026Review
- A Novel In Vitro Assay Correlates Insulin Receptor Autoantibodies With Fasting Insulin in Type B Insulin Resistance.The Journal of clinical endocrinology and metabolism · 2023Article
- Case report: Allogeneic stem cell transplantation for type B insulin resistance.Frontiers in medicine · 2023Article
- Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus.Case reports in medicine · 2022Article
- Insulin Receptor Autoantibody-mediated Hypoglycemia in a Woman With Mixed Connective Tissue Disease.Journal of the Endocrine Society · 2022Article
- Autoimmune hypoglycemia expands the biological spectrum of HHV8+ multicentric Castleman disease.Blood advances · 2021Article
- Article
- Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study.Journal of diabetes research · 2020Observational
- Successful remission of type B insulin resistance syndrome without rituximab in an elderly male.Endocrinology, diabetes & metabolism case reports · 2020Article
- A case of type B insulin resistance syndrome treated with low-dose glucocorticoids.Endocrinology, diabetes & metabolism case reports · 2019Article
- Paradigm shift in the management of type B insulin resistance.Annals of translational medicine · 2018Article
- Successful treatment of type B insulin resistance with mixed connective tissue disease by pulse glucocorticoids and cyclophosphamide.Journal of diabetes investigation · 2017Article
- Novel Management of Insulin Autoimmune Syndrome with Rituximab and Continuous Glucose Monitoring.The Journal of clinical endocrinology and metabolism · 2016Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
Abstract
contextType B insulin resistance is a very rare disease caused by autoantibodies against the insulin receptor. The mortality of type B insulin resistance is high (>50%), and management of this disease is not yet standardized. We report the successful treatment of a patient with type B insulin resistance with rituximab, cyclophosphamide, and prednisone. CASE DESCRIPTION: A 45-year-old woman presented with unintended weight loss of 20 kg, unusually widespread acanthosis nigricans, and glucose levels > 500 mg/dL, which could not be controlled with up to 600 IU/d of insulin. Because of the severity of the insulin resistance combined with features of insulin deficiency, type B insulin resistance was suspected. Detection of high levels of insulin receptor autoantibodies confirmed the diagnosis. Neither immunosuppressive therapy with Ig iv nor plasmapheresis had an effect on glucose levels or insulin dose. Because the patient's condition was deteriorating, we started rituximab (750 mg/m(2) in two doses 2 wk apart) together with cyclophosphamide (100 mg/d orally) and dexamethasone 40 mg/d for 4 days. Two months after initiation of rituximab therapy, fasting glucose levels ranged from 80 to 110 mg/dL and could be controlled with very low insulin doses. Glycated hemoglobin decreased from 11.8 to 6.5%. Two months later, insulin therapy was stopped, and the patient showed normal blood glucose readings.
conclusionIn this patient with type B insulin resistance, Ig treatment and plasmapheresis failed to improve the condition. Finally, treatment with rituximab, cyclophosphamide, and steroids was successful in inducing a complete remission.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.