Document Detail

Recurrent hypoglycemia during pregnancies in a woman with multiple autoantibodies including anti-insulin receptor antibody and anti-platelet antibody, whose serum lowered murine blood glucose levels and phosphorylated insulin receptor of CHO-IR cells.
MedLine Citation:
PMID:  21931226     Owner:  NLM     Status:  MEDLINE    
We report a rare case of recurrent hypoglycemia in a pregnant woman during the period of pregnancies. She suffered from severe hypoglycemia and intrauterine fetal death during the first pregnancy. Thereafter, there was no hypoglycemia, and no obvious cause of hypoglycemia was found by close examinations. Two years later, at eight weeks into the second pregnancy, hypoglycemia recurred. The patient had multiple auto-antibodies including anti-insulin receptor antibody and anti-platelet antibody associated with decreased platelet count. She completed the pregnancy with continuous intravenous administration of glucose that prevented hypoglycemia and finally delivered a healthy baby by Caesarian section. Both the hypoglycemia and thrombocytopenia, and the auto-antibodies disappeared after the delivery. We analyzed the patient's serum as a possible cause of hypoglycemia. Administration of the serum lowered blood glucose levels of mice more strongly than control serum. In addition, the serum phosphorylated tyrosine of insulin receptor of Chinese hamster ovary cells overexpressing human insulin receptors (CHO-IR cells) in vitro. These results suggest that multiple auto-antibodies might have been induced by a trigger of pregnancy, although the precise mechanism was unclear, and the anti-insulin receptor antibody and anti-platelet antibody might have induced hypoglycemia and thrombocytopenia, respectively, during the pregnancy.
Makiko Toshihiro; Hideki Katagiri; Koujiro Kataoka; Akimune Fukushima; Toshie Segawa; Takuya Fujiwara; Isao Hikichi; Noriko Takebe; Jo Satoh
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-09-17
Journal Detail:
Title:  Endocrine journal     Volume:  58     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-12-27     Completed Date:  2012-04-24     Revised Date:  2012-05-03    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1037-43     Citation Subset:  IM    
Division of Diabetes and Metabolism, Iwate Medical University School of Medicine, Morioka, Japan.
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MeSH Terms
Autoantibodies / blood*,  pharmacology
Blood Platelets / immunology*
CHO Cells
Cesarean Section
Glucose / therapeutic use
Hypoglycemia / immunology*,  prevention & control
Infant, Newborn
Insulin Antibodies / immunology
Pregnancy Complications, Hematologic / immunology*
Receptor, Insulin / immunology*
Thrombocytopenia / complications*
Reg. No./Substance:
0/Autoantibodies; 0/Insulin Antibodies; 50-99-7/Glucose; EC, Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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