探讨胰岛素自身免疫综合征(IAS)的诊断学特征。

回顾性分析2016年5月19日中山大学附属第三医院内分泌科收治的1例IAS患者的临床资料，并复习相关文献。

患者女性，19岁，Graves病史1年，服用甲巯咪唑10余天出现严重低血糖。血糖2.73 mmol/L时胰岛素释放指数为4.13；空腹胰岛素/C肽波动于8.20～15.12；胰岛素抗体(IAA)强阳性；腹部增强核磁共振(MR)显示胰腺未见异常。

自身免疫疾病患者特别是服用含巯基药物时，如果出现低血糖，要警惕IAS。

To explore the diagnostic features of insulin autoimmune syndrome (IAS).

A retrospective analysis was performed in one patient diagnosed as IAS in Department of Endocrinology of the Third Affiliated Hospital of Sun Yat-sen University. Then the relevant literatures were reviewed.

A 19-year female patient with Graves disease suffered from serious hypoglycemia after she had taken Methimazole for more than ten days. The insulin releasing index was 4.13 when her blood glucose was 2.73 mmol/L. The ratios of fasting insulin/fasting C-peptide were within 8.20-15.12. The insulin auto-antibody (IAA) was positive. The patient′s pancreas was normal in abdomen enhanced MR.

IAS should be considered when a patient with autoimmune disease suffers from hypoglycemia, especially while the patient is taking sulfhydryl-containing drugs.