{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T07:01:47Z","timestamp":1771830107200,"version":"3.50.1"},"reference-count":32,"publisher":"Walter de Gruyter GmbH","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We describe the case of a 54-year-old Caucasian Italian male experiencing episodes of hypoglycemia, occurring mainly after meals. He had never been exposed to insulin and was taking ramipril, flecainide and acetylsalicylic acid. An oral glucose tolerance test (OGTT) showed high blood glucose levels diagnostic for diabetes mellitus at 120 min and hypoglycemia with inappropriately high insulin levels at 240 min. The 72-h fasting test, abdominal computed tomography (CT) and positron emission tomography-CT were normal. Insulin autoantibodies were positive at high titers, prompting a diagnosis of insulin autoimmune syndrome (IAS). The patient was advised to take frequent, small meals and thus achieved a good control of his hypoglycemic symptoms. After 18 months of this dietary management, his insulin autoantibody levels decreased considerably but remained detectable. During an OGTT, his blood glucose levels at 120 min were now indicative of an impaired glucose tolerance rather than diabetes, and there was improvement in the glucose nadir. The patient had no other clinical or latent autoimmune diseases. Here we discuss the main features of IAS (also known as Hirata\u2019s disease) and review the cases of IAS reported in Italy to date.<\/jats:p>","DOI":"10.1515\/cclm-2017-0392","type":"journal-article","created":{"date-parts":[[2017,9,16]],"date-time":"2017-09-16T06:01:29Z","timestamp":1505541689000},"page":"889-895","source":"Crossref","is-referenced-by-count":26,"title":["Insulin autoimmune syndrome (Hirata\u2019s disease) in an Italian patient: a case report and review of the literature"],"prefix":"10.1515","volume":"56","author":[{"given":"Simona","family":"Censi","sequence":"first","affiliation":[{"name":"Endocrinology Unit , Azienda Ospedaliera-Universitaria di Padova , Department of Medicine (DIMED) , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Paola","family":"Albergoni","sequence":"additional","affiliation":[{"name":"Blood Transfusion Center , Azienda Ospedaliera \u2013 Universitaria di Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Gallo","sequence":"additional","affiliation":[{"name":"Laboratory Medicine , Azienda Ospedaliera-Universitaria di Padova , Department of Medicine (DIMED) , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-1711","authenticated-orcid":false,"given":"Mario","family":"Plebani","sequence":"additional","affiliation":[{"name":"Laboratory Medicine , Azienda Ospedaliera-Universitaria di Padova , Department of Medicine (DIMED) , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Boscaro","sequence":"additional","affiliation":[{"name":"Endocrinology Unit , Azienda Ospedaliera-Universitaria di Padova , Department of Medicine (DIMED) , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Betterle","sequence":"additional","affiliation":[{"name":"Endocrine Unit , Department of Medicine (DIMED) , Universit\u00e0 di Padova , Via Ospedale Civile 105 , 35128 Padova , Italy , Phone: (+39) 049.8214273, Fax: (+39) 049.657391"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,9,16]]},"reference":[{"key":"2026022306062965674_j_cclm-2017-0392_ref_001_w2aab3b7b1b1b6b1ab2b2b1Aa","unstructured":"Hirata Y, Ishizu H, Ouchi N, Motomura S, Abe M, Hara Y, et al. Insulin autoimmunity in a case of spontaneous hypoglycemia. J Jpn Diabetes Soc 1970;13:312\u201320."},{"key":"2026022306062965674_j_cclm-2017-0392_ref_002_w2aab3b7b1b1b6b1ab2b2b2Aa","doi-asserted-by":"crossref","unstructured":"Lupsa MD, Chong AY, Cochran EK, Soos MA, Semple RK, Gorden P. Autoimmune forms of hypoglycemia. Medicine (Baltimore) 2009;88:141\u201353.","DOI":"10.1097\/MD.0b013e3181a5b42e"},{"key":"2026022306062965674_j_cclm-2017-0392_ref_003_w2aab3b7b1b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER, et al. Evaluation and management of adult hypoglycemic disorders: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2009;94:709\u201328.","DOI":"10.1210\/jc.2008-1410"},{"key":"2026022306062965674_j_cclm-2017-0392_ref_004_w2aab3b7b1b1b6b1ab2b2b4Aa","doi-asserted-by":"crossref","unstructured":"Ismail AA. 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