An Unusual Cause of Hypoglycemia: Insulin Autoimmune Syndrome

Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia characterized by antibodies to endogenous insulin without exposure exogenous insulin. In this report, we presented case with history fasting hypoglycemia. After work up and exlusion other causes such as insulinoma, hypogylcemic state the patient was considered have been induced etofenamate. Although IAS generally self limiting dietary management withdrawal trigger drug are enough maintain euglycemia, in some cases corticosteroids, plasmapheresis, rituximab can be used for treatment. our case, despite management, severe patient’s life quality adversely effected. treatment prednisolone, hypoglycemic episodes became less frequent. should differential diagnosis states avoid unnecessary interventions.