ArticleFrontiers in endocrinology2022
Type 1 diabetes complicated with cyclic vomiting syndrome and exogenous insulin antibody syndrome: A case report.
Article in Frontiers in endocrinology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- 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
- 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
- Clinical characteristics and individualized treatment strategies for children with type 1 diabetes and exogenous insulin antibody syndrome: a retrospective case series and literature review.Frontiers in endocrinology · 2026Review
- 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
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Every fifth individual with type 1 diabetes (T1D) suffers from an additional autoimmune disorder due to shared genetic factors and dysregulated immunity. Here we report an extremely rare case of T1D complicated with cyclic vomiting and hypoglycaemia. A 27-year-old Chinese woman with 14-year history of T1D was periodically hospitalized for severe vomiting of more than 30 times a day without apparent organic causes. The vomiting developed acutely and remitted spontaneously after 2-3 days, followed with intractable hypoglycaemia for another 3-4 days during the hospitalization. A few weeks after discharge, she was admitted once again with the same symptoms and disease course. Cyclic vomiting syndrome (CVS) was diagnosed according to the Rome IV criteria, a system developed to define the functional gastrointestinal disorders. Dynamic association and disassociation of exogenous insulin and insulin antibodies (IAs) were identified in her blood during hypoglycaemia, leading to the diagnosis of exogenous insulin antibody syndrome (EIAS). Treatment with rituximab to suppress the IAs was associated with a striking amelioration of hypoglycaemia. Unexpectedly, the episodes of cyclic vomiting were also dramatically reduced. In conclusion, we identified the first case with alternating CVS and EIAS in the setting of T1D. Dynamic measurements of free and total insulin are helpful for the diagnosis of EIAS. CVS is likely to be a latent autoimmune disorder considering the good response to rituximab treatment.
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