Open AccessEfficacy of oral glucocorticoid and cyclosporine in a case of rituximab‐refractory type B insulin resistance syndrome
Author(s) -
Takei Masahiro,
Ishii Hiroaki,
Kawai Yuko,
Kato Kosuke,
Sekido Takashi,
Sato Yoshihiko,
Takeda Teiji,
Komatsu Mitsuhisa
Publication year - 2015
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12337
Subject(s) - medicine , insulin resistance , rituximab , prednisolone , refractory (planetary science) , glucocorticoid , insulin , endocrinology , gastroenterology , physics , lymphoma , astrobiology
We describe a case of type B insulin resistance syndrome associated with systemic lupus erythematosus ( SLE ) that was refractory to rituximab and successfully treated with a combination of oral glucocorticoids and cyclosporine. Prior to treatment, insulin resistance was severe, and application of a hyperinsulinemic euglycemic clamp was not possible despite the continuous intravenous infusion of insulin at a maximum rate of 9.0 mU /kg/min. The addition of cyclosporine to oral glucocorticoid therapy resulted in remission of insulin resistance. The combination of oral prednisolone and cyclosporine might be effective in treating type B insulin resistance syndrome, particularly in rituximab‐resistant cases. However, nephrotoxicity is a particular concern for patients receiving long‐term cyclosporine therapy.