Monoclonal Gammopathy-induced Insulin “Autoimmune” Syndrome.
Monoclonal Gammopathy-induced Insulin “Autoimmune” Syndrome.
| Citation / Year of Report | Age (y) / Gender (M/F) | Monoclonal Ig Isotype | Insulin Antibodies Kinetics | Evidence |
|---|---|---|---|---|
| Essential Monoclonal Gammopathy | ||||
| 4 / 1986 | 63 / M | IgG-kappa | Capacity (estimated): 240×10−6 mol L−1
Affinity (estimated): Ka=0.2×106 L mol−1 |
Specific binding of monoclonal IgG-kappa to insulin |
| 5 / 1989 | 64 / M | IgG-lambda | Capacity: 1.7×10−6 mol L−1
Affinity: Ka=1.6×106 L mol−1 |
Specific binding of monoclonal IgG-lambda to insulin |
| 9 / 1993 | 48 / F | IgG (light chain type not reported) | Capacity: Not described
Affinity: Ka=4.0×105 L mol−1 |
Anti-insulin antibodies identifiable by polyethylene glycol precipitation. 125I-insulin binding by autoradiography to monoclonal IgG on agarose gel electrophoretic separation in an amount that can be decreased by unlabeled insulin |
| 10 / 2004 | 83 / F | IgG-kappa | Capacity 1.9×10−5 mol L−1
Affinity: Ka=1.4×106 L mol−1 |
Anti-insulin antibody corresponded to the monoclonal IgG |
| Myeloma | ||||
| 3 / 1972 | 61 / F | IgA (light chain type not known) | Not studied | Hypoglycemia attacks presenting symptom of myeloma. Posited that the hypoglycemia was in some way related to myeloma |
| 6* / 1990 | 53 / M | IgG-kappa | Not studied | Disappearance of monoclonal IgG-kappa after radiation of sacral lesion and chemotherapy and coincidental disappearance of hypoglycemic episodes and elevated insulin levels |
| 7 / 1992 | 73 / M | IgG-lambda | Capacity: 27×10−6 mol L−1
Affinity: Ka=0.085×106 L mol−1 |
Affinity of IgG-lambda for insulin demonstrated |
| 8 / 1992 | 78 / M | IgG-kappa | Not studied | IgG-kappa monoclonal immunoglobulin shown to be anti-insulin antibody |
| 11 / 2007 | 72 / M | IgA-kappa | Capacity 5.7×10−4 mol L−1
Affinity: Kd=0.32×10−6 mol L−1 |
IgA-kappa monoclonal immunoglobulin shown to be a low-affinity, high-capacity anti-insulin antibody |
| 12 / 2012 | 63 / M | IgG3-kappa and IgG3-lambda component with insulin-binding capability | Capacity: Not reported
Affinity: Ka=7×106 L mol−1 |
Anti-insulin IgG3-lambda monoclonal antibody distinct from the primary myeloma clone monoclonal IgG3-kappa. Elevated anti-insulin antibody titers and hypoglycemic attacks were closely associated with escape of myeloma from suppression by therapy |