ArticleThe Journal of clinical endocrinology and metabolism2016
Novel Management of Insulin Autoimmune Syndrome with Rituximab and Continuous Glucose Monitoring.
Article in The Journal of clinical endocrinology and metabolism, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 62 citations in OpenAlex.
- Alpha-lipoic acid as a trigger of insulin autoimmune syndrome: Current evidence, a case-based approach, diagnostic pitfalls, and practical management.Metabolism open · 2026Review
- Ovarian stimulation toward oocyte cryopreservation for fertility preservation in a patient with Hirata syndrome: a clinical challenge in assisted reproduction.Archives of gynecology and obstetrics · 2026Article
- A case report and literature review of proton pump inhibitors inducing insulin autoimmune syndrome.Frontiers in endocrinology · 2026Review
- Unmasking Hirata: a mysterious case of Hypoglycemia triggered by immunologic storm.Oxford medical case reports · 2026Article
- Hirata Syndrome in a Woman With Graves' Disease Without Exposure to Thionamides and Summary of Cases from South America.JCEM case reports · 2025Article
- Successful treatment with rituximab of a type 2 diabetes patient with antibody-mediated insulin resistance syndrome: A case report.Medicine · 2025Article
- Insulin autoimmune syndrome in a 3-year-old boy: the youngest to date in China and a narrow review.BMC pediatrics · 2025Review
- Insulin Autoimmune Syndrome: A Chinese Expert Consensus Statement.Aging medicine (Milton (N.S.W)) · 2025Article
- Case Report: Exogenous insulin antibody syndrome complicated with chronic renal failure and long-term history of type 2 diabetes: report of two cases.Frontiers in endocrinology · 2025Article
- Autoimmune Hypoglycemia in Type 2 Diabetes: A Case of Thiocolchicoside-Induced Steroid-Refractory Insulin Autoimmune Syndrome.Clinical diabetes : a publication of the American Diabetes Association · 2025Article
- Article
- Insulin Autoimmune Syndrome: A Systematic Review.International journal of endocrinology · 2023Review
- Production of insulin antibody associated with relapsed hodgkin's lymphoma.Diabetology international · 2022Article
- [Insulin autoimmune syndrome : A rare, but important differential diagnosis of hypoglycemia].Der Internist · 2022Article
- Case Report: Recurrent Autoimmune Hypoglycemia Induced by Non-Hypoglycemic Medications.Frontiers in immunology · 2022Review
- Steroid-Refractory Insulin Autoimmune Syndrome Treated With Rituximab and Continuous Glucose Monitoring.Cureus · 2021Article
- Increased C-Peptide Immunoreactivity in Insulin Autoimmune Syndrome (Hirata Disease) Due to High Molecular Weight Proinsulin.Clinical chemistry · 2021Article
- Analysis of the clinical characteristics of insulin autoimmune syndrome induced by exogenous insulin in diabetic patients.Diabetology & metabolic syndrome · 2021Article
- Long-term follow-up of insulin autoimmune syndrome in an elderly patient.Clinical case reports · 2020Article
- Methimazole-induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review.Experimental and therapeutic medicine · 2020Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
contextInsulin autoimmune syndrome (IAS), or Hirata's disease, is a rare hypoglycemic disorder characterized by spontaneous hypoglycemia without evidence of exogenous insulin administration, a high serum concentration of total immunoreactive insulin, and the presence of insulin autoantibodies in high titer. The majority of cases occur in the Asian population, and treatment is generally successful with watchful waiting or steroids. CASE DESCRIPTION: We report the case of a 71-year-old Caucasian man with severe hypoglycemia due to IAS that was refractory to a prolonged course of high-dose steroids. Type 1 diabetes prevention trials using rituximab have shown selective suppression of insulin autoantibodies, which are the pathogenic antibodies in IAS, and therefore we provided this therapy. Treatment with two doses of rituximab and daily use of a continuous glucose monitor resulted in disease remission.
conclusionWe present the first case where potentially life-threatening hypoglycemia due to IAS was successfully managed with rituximab and a continuous glucose monitor. We conclude that these treatment modalities are effective for the management of severe, refractory IAS.
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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.