Abstract
ABSTRACT Objective: We report an atypical case of autoimmune hypoglycemia due to anti-insulin receptor antibodies after initiation of human monoclonal antibody denosumab and review the literature on this unusual disorder. Methods: We cite the history of a 30-year-old female treated for systemic lupus erythematosus (SLE) who presented with persistent hypoglycemia. This manifestation first appeared after administration of the anti-osteoporotic drug denosumab. Results: The patient's laboratory evaluation initially showed suppression of insulin and C-peptide levels. After ruling out all possible causes of hypoglycemia with decreased insulin levels, we resolved that the temporal relationship between the administration of denosumab and the occurrence of symptoms suggested the involvement of this drug in the disorder. However, in the course of the disease, laboratory tests showed a switch to hyperglycemia accompanied by markedly elevated insulin and C-peptide levels. A diagnosis of type B insulin resistance was ...
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