Successful treatment with rituximab of a type 2 diabetes patient with antibody-mediated insulin resistance syndrome: A case report


Cakmak R., Tekin S., HACİŞAHİNOĞULLARI H., MUTLU Ü., Caklili O. T., Nasibopva V. S., ...Daha Fazla

MEDICINE, cilt.104, sa.29, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 104 Sayı: 29
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1097/md.0000000000043501
  • Dergi Adı: MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database, Directory of Open Access Journals
  • İstanbul Üniversitesi Adresli: Evet

Özet

Rationale:Insulin antibody-mediated insulin resistance is a rare autoimmune mechanism that can cause severe hyperglycemia.Patient concerns:A 52-year-old male patient was admitted to our hospital with complaints of polydipsia, polyuria, and weight loss (8 kg in 6 months). He was diagnosed with type 2 diabetes mellitus at age 33.Diagnoses:Type 2 diabetes mellitus with antibody-mediated insulin resistance syndrome.Interventions:Rituximab infusion in a 500 mg dose was given 2 times in a 2-week interval.Outcomes:A significant response was achieved 1 month later with fasting plasma glucose: 120 mg/dL (6.7 mmol/L), glycosylated hemoglobin A1c: 7.6% (59.6 mmol/mol), and anti-insulin antibodies: 0.001 U/mL. Clinically improved response persisted for about 6 months.Lessons:Clinicians should be aware of the antibody-mediated insulin resistance, recognize suggestive signs and symptoms, pursue appropriate diagnostic evaluation, and treatment approach.