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