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Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review

  • Authors:
    • Rongfeng Han
    • Xia Jiang
  • View Affiliations / Copyright

    Affiliations: Department of Endocrinology, Tianjin First Center Hospital, Tianjin 300192, P.R. China
    Copyright: © Han et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 93
    |
    Published online on: September 16, 2020
       https://doi.org/10.3892/etm.2020.9221
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Abstract

The patient in the present case report, a 27‑year‑old man, was diagnosed with Graves' disease and hypokalemia. The patient was treated with methimazole and intermittent potassium supplementation. Following treatment, the patient was still suffering from fatigue, accompanied by palpitations, a hand tremor, fear of heat and sweating. Hypoglycemia was revealed by monitoring fingertip blood glucose levels. The laboratory investigations indicated that serum insulin levels were significantly elevated (>1,000 µIU/ml), the test for serum insulin autoantibody (IAA) was positive, and insulin autoimmune syndrome (IAS) was diagnosed. Following symptomatic treatment, the patients insulin levels decreased, and the hypoglycemia episode was gradually relieved. Hypoglycemia may be prone to missed diagnosis in patients with Graves' disease and hypokalemic periodic paralysis. Monitoring fingertip blood glucose level is a convenient and feasible method to detect hypoglycemia. Furthermore, serum insulin and IAA detection should be assessed to exclude or confirm IAS.
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Copy and paste a formatted citation
Spandidos Publications style
Han R and Jiang X: Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review. Exp Ther Med 20: 93, 2020.
APA
Han, R., & Jiang, X. (2020). Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review. Experimental and Therapeutic Medicine, 20, 93. https://doi.org/10.3892/etm.2020.9221
MLA
Han, R., Jiang, X."Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review". Experimental and Therapeutic Medicine 20.5 (2020): 93.
Chicago
Han, R., Jiang, X."Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review". Experimental and Therapeutic Medicine 20, no. 5 (2020): 93. https://doi.org/10.3892/etm.2020.9221
Copy and paste a formatted citation
x
Spandidos Publications style
Han R and Jiang X: Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review. Exp Ther Med 20: 93, 2020.
APA
Han, R., & Jiang, X. (2020). Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review. Experimental and Therapeutic Medicine, 20, 93. https://doi.org/10.3892/etm.2020.9221
MLA
Han, R., Jiang, X."Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review". Experimental and Therapeutic Medicine 20.5 (2020): 93.
Chicago
Han, R., Jiang, X."Methimazole‑induced insulin autoimmune syndrome in Graves' disease with hypokalemia: A case report and literature review". Experimental and Therapeutic Medicine 20, no. 5 (2020): 93. https://doi.org/10.3892/etm.2020.9221
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