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Publication Date:
January 2008
ISSN:
1437-4331
DOI:
10.1515/CCLM.2008.031

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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the International Federation of Clinical Chemistry and Laboratory Medicine and the European Federation of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Lippi, Giuseppe / Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Melichar, Bohuslav / Siest, Gérard / Whitfield, John B. / Abi Fadel, Marianne / Alvarez Menendez, Francisco V. / Azzazy, Hassan M.E. / Diamandis, Eleftherios P. / Eckardstein, Arnold / Favaloro, Emmanuel J. / Griesmacher, Andrea / Herrmann, Wolfgang / Hoffmann, Johannes J.M.L. / Hooijkaas, Herbert / Ichihara, Kiyoshi / Kaabachi, Naziha / Kim, Jeong-Ho / Korte, Wolfgang / Kroupis, Christos / Lai, Leslie Charles / Lam, Wai Kei Christopher / Marc, Janja / Miyoshi, Eiji / Özben, Tomris / Palicka, Vladimir / Panteghini, Mauro / Queralto, Jose M. / Scartezini, Marileia / Simundic, Ana-Maria / Tsongalis, Gregory J. / Wallemacq, Pierre E. / Yan, Shengkai / Young, Ian S. / Chiu, Rossa Wai Kwun / Ghosh, Debabrata / Kappelmayer, Janos / Lehmann, Sylvain / Sypniewska, Grazyna

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The double whammy of endogenous insulin antibodies in non-diabetic subjects

Adel A.A. Ismail1

1“Tanglewood” Chevet Lane, Wakefield, West Yorkshire, UK

Corresponding author: Adel A.A. Ismail, “Tanglewood” Chevet Lane, Wakefield, West Yorkshire, UK Phone: +44-1924-254359,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 46, Issue 2, Pages 153–156, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2008.031, January 2008

Publication History:
Received:
2007-06-28
Accepted:
2007-09-25
Published Online:
2008-01-23

Abstract

The presence of high affinity/avidity endogenous insulin antibodies in significant amounts in non-diabetic individuals could uniquely be a double whammy. Clinically it could trigger pathology, namely hypoglycaemia, and analytically it could cause erroneous and potentially misleading results (i.e., falsely high or falsely low) in the key biochemical parameters essential in the differential diagnosis of this pathology, namely serum insulin, proinsulin and even C-peptide. The purpose of this paper is to highlight the clinical and analytical sequelae of endogenous insulin antibodies in (a) delaying or even confusing the differential diagnosis of unexpected/unexplained hypoglycaemia, and (b) interfering in some immunoassays of pancreatic hormones (commercial or in-house).

Clin Chem Lab Med 2008;46:153–6.

Keywords: analytical interference; autoimmune hypoglycaemia; hypoglycaemia; immunoassays; insulin antibodies; insulin autoimmune syndrome

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