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KMID : 0882420080750000866
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Korean Journal of Medicine
2008 Volume.75 No. 0 p.866 ~ p.869
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A case of insulin autoimmune syndrome that developed after topiramate anti-obesity medication
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Hong Ji-Hyung
Lim Eun-Joo
Lee Jung-Min
Chang Sang-Ah
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Abstract
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Insulin autoimmune syndrome (IAS) is characterized by insulin autoantibodies, hyperinsulinemia, and hypoglycemic symptoms in patients who have not received exogenous insulin injections. A 38-year-old female was admitted complaining of postprandial dizziness and hunger after one month on topiramate for the purpose of losing weight. When her hypoglycemic symptoms were present, her serum glucose level was 42 mg/dL, insulin 227.4 μIU/mL, and C-peptide 5.26 ng/mL, with positive insulin autoantibodies (72.1%) and an increased proinsulin level. Her HLA type was HLA-DR4 positive. Topiramate is both an anticonvulsant and migraine prophylactic. Taking advantage of its adverse effect of weight loss, it has been used as an anti-obesity drug. In addition, it has been reported to induce hypoglycemia, although the mechanism of this has not been determined. Here, we report a case of IAS that occurred after topiramate administration. (Korean J Med 75:S866-S869, 2008)
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KEYWORD
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Insulin autoimmune syndrome, Topiramate, Hypoglycemia
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