Skip to main content
SpringerLink
Log in

La sindrome di Hirata (stato dell’arte)

  • Rassegna
  • Published:
L'Endocrinologo Aims and scope

Sommario

Nella storia naturale delle malattie autoimmuni sono implicati diversi meccanismi autoanticorpo-mediati e/o cellulo-mediati. Nella prima parte dell’articolo vengono presi in considerazione i vari meccanismi immunopatogeni con le malattie relative. Tra questi vi è il meccanismo di tipo VII caratterizzato dalla presenza di un anticorpo che lega un ormone. Nella seconda parte di questo articolo viene presa in considerazione l’epidemiologia, l’eziopatogenesi, la fisiopatologia, le caratteristiche cliniche, immunologiche, genetiche e le implicazioni terapeutiche della sindrome di Hirata. Tale sindrome è caratterizzata da un’ipoglicemia autoimmune dovuta alla presenza di autoanticorpi anti-insulina che si formano spontaneamente o in seguito al contatto dei soggetti con farmaci con un gruppo sulfidrilico o all’acido alfa-lipoico.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Bibliografia

  1. Coombs RR, Gell PG (1975) Classification of allergic reactions responsible for clinical hypersensitivity and disease. In: Gell PG, Coombs RR, Lachmann PJ (eds) Clinical aspects of immunology. Blackwell Sci, Oxford, pp 761–781

    Google Scholar 

  2. Uchigata Y, Hirata Y, Omori Y (1995) A novel concept of type VII hypersensitivity introduced by insulin autoimmune syndrome (Hirata’s disease). Autoimmunity 20:207–208

    Article  CAS  PubMed  Google Scholar 

  3. Cugno M, Castelli R, Marco Cicardi M (2008) Angioedema due to acquired C1-inhibitor deficiency: a bridging condition between autoimmunity and lymphoproliferation. Autoimmunity Reviews 8:156–159

    Article  CAS  PubMed  Google Scholar 

  4. Hirata Y, Ishizu H, Ouchi N et al. (1970) Insulin autoimmunity in a case of spontaneous hypoglycemia. J Jpn Diabetes Soc 13:312–320

    Google Scholar 

  5. Lupsa BC, Chong AY, Cochran EK et al. (2009) Autoimmune forms of hypoglycemia. Medicine 88:141–153

    Article  CAS  PubMed  Google Scholar 

  6. Uchigata Y, Hirata Y, Iwamoto Y (2009) Drug-induced insulin autoimmune syndrome. Diabetes Res Clin Pract 83:e19–e20

    Article  CAS  PubMed  Google Scholar 

  7. Wang YL, Yao PW, Zhang XT et al. (2015) Insulin autoimmune syndrome: 73 cases of clinical analysis. Chin Med J 128:2408–2409

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gopal K, Priya G, Gupta N et al. (2013) A case of autoimmune hypoglycemia outside Japan: rare, but in the era of expanding drug-list, important to suspect. Indian J Endocrinol Metab 17:1117–1119

    Article  PubMed  PubMed Central  Google Scholar 

  9. Uchigata Y, Hirata Y (1999) Insulin autoimmune syndrome (IAS, Hirata disease). Ann Med Intern 150:245–253

    CAS  Google Scholar 

  10. Alves C, Constança J, De León DD et al. (2013) A novel atypical presentation of insulin autoimmune syndrome (Hirata’s disease) in a child. J Pediatr Endocrinol Metab 26:1163–1166

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Furukawa N, Miyamura N, Nishida K et al. (2007) Possible relevance of alpha lipoic acid contained in a health supplement in a case of insulin autoimmune syndrome. Diabetes Res Clin Pract 75:366–367

    Article  PubMed  Google Scholar 

  12. Takeuchi Y, Miyamoto T, Kakizawa T et al. (2007) Insulin autoimmune syndrome possibly caused by alpha lipoic acid. Intern Med 46:237–239

    Article  PubMed  Google Scholar 

  13. Uchigata Y (2007) The novel agent, alpha-lipoic acid, can cause the development if insulin autoimmune syndrome. Intern Med. doi:10.2169/internalmedicine.46.0221

    PubMed  Google Scholar 

  14. Deguchi A, Okauchi Y, Suehara S, Mineo I (2013) Insulin autoimmune syndrome in a health supplement user: the effectiveness of cornstarch therapy for treating hypoglycemia. Insulin autoimmune syndrome in a health supplement user: the effectiveness of cornstarch therapy for treating hypoglycemia. Intern Med 52:369–372

    Article  PubMed  Google Scholar 

  15. Uchigata Y, Kuwata S, Tokunaga K et al. (1992) Strong association of insulin autoimmune syndrome with HLA-DR4. Lancet 339:393–395

    Article  CAS  PubMed  Google Scholar 

  16. Uchigata Y, Tokunaga K, Nepom G et al. (1995) Differential immunogenetic determinants of polyclonal insulin autoimmune syndrome (Hirata’s disease) and monoclonal insulin autoimmune syndrome. Diabetes 44:1227–1232

    Article  CAS  PubMed  Google Scholar 

  17. Uchigata Y, Hirata Y, Omori Y et al. (2000) Worldwide differences in the incidence of insulin autoimmune syndrome (Hirata disease) with respect to the evolution of HLA-DR4 alleles. Hum Immunol 61:154–157

    Article  CAS  PubMed  Google Scholar 

  18. Uchigata Y, Kuwata S, Tsushima T et al. (1993) Patients with Graves’ disease who developed insulin autoimmune syndrome (Hirata disease) possess HLA-Bw62/Cw4/DR4 carrying DRB1∗0406. J Clin Endocrinol Metab 77:249–254

    CAS  PubMed  Google Scholar 

  19. Gullo D, Evans JL, Sortino G et al. (2014) Insulin autoimmune syndrome (Hirata Disease) in European Caucasians taking \(\upalpha\)-lipoic acid. Clin Endocrinol 81:204–209

    Article  CAS  Google Scholar 

  20. Matsushita S, Takahashi K, Motoki M et al. (1994) Allele specificity of structural requirement for peptides bound to HLA-DRB1∗0405 and -DRB1∗0406 complexes: implication for the HLA-associated susceptibility to methimazole induced insulin autoimmune syndrome. J Exp Med 180:873–883

    Article  CAS  PubMed  Google Scholar 

  21. Uchigata Y, Eguchi Y, Takayama-Hasumi S, Omori Y (1994) Insulin autoimmune syndrome (Hirata disease): clinical features and epidemiology in Japan. Diabetes Res Clin Pract 22:89–94

    Article  CAS  PubMed  Google Scholar 

  22. Greenbaum CJ, Palmer JP, Kuglin B, Kolb H (1992) Insulin autoantibodies measured by radioimmunoassay methodology are more related to insulin-dependent diabetes mellitus than those measured by enzyme-linked immunosorbent assay: results of the fourth international workshop on the standardization of insulin autoantibody measurement. J Clin Endocrinol Metab 74:1040–1044

    CAS  PubMed  Google Scholar 

  23. Meschi F, Dozio N, Bognetti E et al. (1992) An unusual case of recurrent hypoglycaemia: 10-year follow up of a child with insulin auto-immunity. Eur J Pediatr 151:32–34

    Article  CAS  PubMed  Google Scholar 

  24. Dozio N, Scavini M, Beretta A et al. (1998) Imaging of the buffering effect of insulin antibodies in the autoimmune hypoglycemic syndrome. J Clin Endocrinol Metab 83:643–648

    CAS  PubMed  Google Scholar 

  25. Annese S, Fadini G, Maran A (2008) Caso di Ipogligemia autoimmune trattata con plasmaferesi. Giornale It Diabetol Metab 28:162–164

    Google Scholar 

  26. Bresciani E, Bussi A, Bazzigaluppi E, Balestrieri G (2011) Insulin autoimmune syndrome induced by \(\upalpha\)-lipoic acid in a Caucasian woman: case report. Diabetes Care 34:e146

    Article  PubMed  PubMed Central  Google Scholar 

  27. Balestrieri A, Magnani E, Ragazzini C, Pasini G (2015) Primary insulin autoimmune syndrome in an Italian woman: a case report. Ital J Med 9:169–172

    Article  Google Scholar 

  28. Petrone A, Giorgi G, Galgani A et al. (2005) CT60 single nucleotide polymorphisms of the cytotoxic T-lymphocyte-associated antigen-4 gene region is associated with Graves’ disease in an Italian population. Thyroid 15:232–238

    Article  CAS  PubMed  Google Scholar 

  29. Nasu T, Suzuki R, Okamoto Y et al. (2011) Late postprandial hypoglycemia due to bioactive insulin dissociation from autoantibody leading to unconsciousness in a patient with insulin autoimmune syndrome. Intern Med 50:339–343

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. U.O.C. di Endocrinologia, Università degli Studi di Padova, Via Ospedale Civile 105, 35128, Padova, Italia

    Corrado Betterle

  2. U.O.C. di Medicina Interna, Ospedale dell’Angelo, Azienda Ospedaliera Veneziana, via Paccagnella 11, 30174, Mestre-Venezia, Italia

    Fabio Presotto

Authors
  1. Corrado Betterle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabio Presotto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Corrado Betterle.

Ethics declarations

Conflitto di interesse

Gli autori Corrado Betterle e Fabio Presotto dichiarano di non avere conflitti di interesse.

Consenso informato

Lo studio presentato in questo articolo non ha richiesto sperimentazione umana.

Studi sugli animali

Gli autori di questo articolo non hanno eseguito studi sugli animali.

Additional information

Proposto da Corrado Betterle.

Materiale elettronico supplementare

I link al materiale elettronico supplementare sono elencati qui sotto.

(DOC 26 kB)

(DOC 25 kB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Betterle, C., Presotto, F. La sindrome di Hirata (stato dell’arte). L'Endocrinologo 17, 82–89 (2016). https://doi.org/10.1007/s40619-016-0189-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40619-016-0189-7

Parole chiave

Search

Navigation