ReviewDiabetes, metabolic syndrome and obesity : targets and therapy2020
Insulin Autoimmune Syndrome (Hirata Disease): A Comprehensive Review Fifty Years After Its First Description.
Review in Diabetes, metabolic syndrome and obesity : targets and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers.
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Who cites it
82 citing papers in PubMed, 116 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
- Article
- Insulin autoimmune hypoglycemia unmasking monoclonal gammopathy in type 2 diabetes.JCEM case reports · 2026Article
- Hirata's Disease: A Case Report.Journal of the ASEAN Federation of Endocrine Societies · 2026Article
- An Ultrasensitive Label-Free Aptasensor for Insulin Detection Assisted by Exonuclease III and 2-Aminopurine.Molecules (Basel, Switzerland) · 2026Article
- Article
- Hypoglycemia in diabetes with low-affinity insulin antibody successfully improved by treating sleep apnea syndrome.JCEM case reports · 2026Article
- A Rare Case of Idiopathic Rapid Gastric Emptying.Cureus · 2026Article
- Insulin Autoimmune Syndrome Associated With Hashimoto Thyroiditis and Nodular Thyroid Disease: Clinical Management With Flash Glucose Monitoring and Prednisolone Therapy.The American journal of case reports · 2026Article
- 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
- Clinical Characteristics and Risk Factors of Exogenous Insulin Antibody Syndrome in Patients with Diabetes: A Retrospective Cross-Sectional Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- A Case of Antibody-Mediated Recurrent Hypoglycemia in a Patient With Mixed Connective Tissue Disease.Cureus · 2026Article
- Macrohormones in endocrinology: prevalence, clinical impact, and diagnostic approaches.Frontiers in endocrinology · 2026Review
- Diagnostic utility of the insulin-to-C-peptide molar ratio in differentiating insulin autoimmune syndrome and exogenous insulin antibody syndrome from insulinoma.Frontiers in endocrinology · 2026Article
- Unmasking Hirata: a mysterious case of Hypoglycemia triggered by immunologic storm.Oxford medical case reports · 2026Article
- A case report and literature review of proton pump inhibitors inducing insulin autoimmune syndrome.Frontiers in endocrinology · 2026Review
- Diagnostic efficacy of fasting insulin-to-C-peptide ratio in exogenous insulin autoimmune syndrome.Frontiers in medicine · 2026Article
- Hyperinsulinemic hypoglycemia due to pathogenic INSR variants: metabolic signature, phenotypic overlap, and semidominant inheritance.Frontiers in endocrinology · 2026Article
- Hirata Syndrome Clinical Presentation and Management: A Single-Centre Experience.Journal of the ASEAN Federation of Endocrine Societies · 2025Article
- Cdc42 Activation in Antinephrin Antibody-Induced Nephropathy.Journal of the American Society of Nephrology : JASN · 2025Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Insulin autoimmune syndrome (IAS), also named Hirata's disease, is a rare condition characterized by hypoglycemic episodes due to the presence of high titers of insulin autoantibodies (IAA). IAS is a form of immune-mediated hypoglycemia, which develops when a triggering factor (ie, a medication or a viral infection) acts on an underlying predisposing genetic background. IAS pathogenesis involves the formation of insulin-IAA complexes that induce glycemic alterations with a double-phase mechanism: IAA prevent insulin to bind its receptor in the postprandial phase, possibly resulting in mild hyperglycemia; thereafter, insulin is released from the complexes irrespective of blood glucose concentrations, thus inducing hypoglycemia. The diagnosis of IAS is challenging, requiring a careful workup aimed at excluding other causes of hyperinsulinemic hypoglycemia. The gold standard for the definitive diagnosis is the finding of IAA in a blood sample. Because IAS is frequently a self-remitting disease, its management mostly consists of supportive measures, such as dietary modifications, aimed at preventing the development of hypoglycemia. Pharmacological therapies may occasionally be necessary for patients presenting with severe manifestations of IAS. Available therapies may include drugs that reduce pancreatic insulin secretion (somatostatin analogues and diazoxide, for instance) and immunosuppressive agents (glucocorticoids, azathioprine and rituximab). The purpose of this review is to provide a comprehensive analysis of the disease, by describing the burden of knowledge that has been obtained in the 50 years following its first description, took in 1970, and by highlighting the points that are still unclear in its pathogenesis and management.
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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.