Abstract
Since a new type of hypoglycemia associated with insulin auto-immune antibodies was reported by Hirata in 1970, 20 cases of this syndrome have been reported. in patients between 21 and 77 years of age, with the exception of one baby whose hypoglycemia was reportedly due to it's mother's insulin auto-immune antibodies conveyed through the placenta.
An 8-year-old girl, the youngest patient with insulin auto-immune syndrome, received a traffic injury on July 20, 1976, She complained of a headache, and diphenylhydantoin and other drugs were administered. From the beginning of September 1976, she showed hypoglycemic reactions, and in the early morning of September 24th, 1976, she lost consciousness. At that time, her fasting blood glucose was below 30 mg/dl, and she regained consciousness after an intravenous glucouse infusion. Diuranal blood glucose levels, revealed hypoglycemia but an oral glucose tolerance test showed a diabetic pattern. Insulin antibodies were found in the patient's serum although she had never received exogenous insulin. Factitious hypoglycemia was ruled out in this patient because she was so young, and she had never been diagnosed as being diabetic. No one in her family was diabetic so she was not familiar with insulin.
Using a specific precipitation method, insulin-binding immunoglobulins were found only in IgG, and light chains of the immunoglobulins binding with insulin were classified mainly as a kappa type. The patient's HLA antigens, especially B-locus, were determined as B 15 and BW 54.
