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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.

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

Huy A Tran, Director and Associate Professor, Department of Clinical Chemistry
Glenn E Reeves, Director, Department of Immunopathology
Hunter Area Pathology Service, Newcastle University, Newcastle, NSW.
Article References: 
Reference Text: 
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.
Reference Order: 
1
PubMed ID: 
11889410
Reference Text: 
Flier JS, Kahn CR, Roth J. Receptors, antireceptor antibodies and mechanisms of insulin resistance. N Engl J Med 1979; 300: 413-419.
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2
PubMed ID: 
366414
Reference Text: 
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.
Reference Order: 
3
PubMed ID: 
176581
Reference Text: 
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.
Reference Order: 
4
PubMed ID: 
9702422
Reference Text: 
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.
Reference Order: 
5
PubMed ID: 
14724317

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