Objective To explor the clinical characteristics of insulin autoimmune syndrome induced by lipoic acid.Methods Cases of insulin autoimmune syndrome caused by lipoic acid were collected and analyzed statistically in China and abroad, extracted literatures were analyzed statistically in respects of patient’s gender, nationality, age, primary disease, combined drugs, insulin autoimmune syndrome occurrence time, insulin autoimmune syndrome related laboratory examination, main symptoms, clinical intervention measures and outcome. At the same time, the drug instructions of four domestic manufacturers were consulted and analyzed.Results The 21 patients included in the analysis were 4 males and 17 females. The age ranged from 32 to 77 years, with an average of 57.71 years. 11 patients were combined with other drugs, of which 5 patients were combined with insulin or insulin secretagogue such as gliclazide, 5 patients were treated with metformin or acarbose. IAS occurred in 4 patients and 12 patients after stopping lipoic acid, the average blood glucose was 2.46 mmol/L at the onset of hypoglycemia. The serum insulin level of 21 patients was higher than normal, insulin autoantibody (IAA) was positive. Genotypes were detected in 14 patients, the genotypes of Chinese, Japanese and Korean patients were HLA-DRB1*0406, and those of non East Asian patients were HLA-DRB1*0403 or HLADRB1*0415. Lipoic acid was stopped in 21 patients, of which 6 patients did not interfere with the improvement after drug withdrawal, 9 patients were treated with glucocorticoid, 1 patient was treated with diazoxide, 1 patient was treated with glucocorticoid and did not improve, finally plasma exchange treatment was given, all patients were improved.Conclusion When lipoic acid is used to produce hypoglycemic symptoms, we should be alert to insulin autoimmune syndrome, strengthen medication monitoring in the process of clinical medication, and relevant enterprises should improve the drug instructions and ensure patients safety.

R977

陜西省重點(diǎn)研發(fā)計(jì)劃一般項(xiàng)目(2021SF-226);陜西省重點(diǎn)研發(fā)計(jì)劃一般項(xiàng)目(2020SF-062)