To the Editor: Type B insulin resistance is an uncommon syndrome characterised by abnormal glucose homeostasis (hypo- and/or hyperglycaemia), the presence of insulin receptor (IRec) autoantibodies, and intact IRec structure. It occurs mostly in African Americans, often with coexisting autoimmune disease.1
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Treatment of type B insulin resistance with immunoglobulin: novel use of an old therapy
Huy A Tran and Glenn E Reeves
Med J Aust 2009; 190 (3): 168.
Huy A Tran, Director and Associate Professor, Department of Clinical Chemistry
Glenn E Reeves, Director, Department of Immunopathology
Arioglu E, Andewelt A, Diabo C, et al. Clinical course of the syndrome of autoantibodies to the insulin receptor (type B insulin resistance): a 28-year perspective. Medicine (Baltimore) 2002; 81: 87-100.
Flier JS, Kahn CR, Roth J. Receptors, antireceptor antibodies and mechanisms of insulin resistance. N Engl J Med 1979; 300: 413-419.
Kahn CR, Flier JS, Bar RS, et al. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med 1976; 294: 739-745.
Eriksson JW, Bremell T, Eliasson B, et al. Successful treatment with plasmapheresis, cyclophosphamide, and cyclosporin A in type B syndrome of insulin resistance. Case report. Diabetes Care 1998; 21: 1217-1220.
Coll AP, Thomas S, Mufti GJ. Rituximab therapy for the type B syndrome of severe insulin resistance. N Engl J Med 2004; 350: 310-311.
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