关键词: 外源性胰岛素自身免疫综合征, 自身免疫性, 胰岛素, 自身抗体

Abstract: Objective　To investigate the clinical characteristics of exogenous insulin autoimmune syndrome（EIAS），to understand clinical diagnosis and treatment process and its characteristics of EIAS in combination with literature，and to improve clinicians' skills in diagnosis and treatment of the disease.Methods　From January 2010 to March 2019，ten patients with EIAS diagnosed in the Department of Endocrinology of Affiliated Hospital of Inner Mongolia Medical University were selected.A retrospective summary of the patient's general condition，laboratory examination，treatment and prognosis was made.Results　There were 5 males and 5 females aged 35-83 years with diabetes mellitus of 7-23 years.The onset of hypoglycemia was mostly fasting hypoglycemia.All cases had a long history of insulin therapy.The combined immune diseases were eczema-like rash in one case，psoriasis in one case.Antibody test results showed that serum islet cell antibody （ICA），antibody of glutamic acid decarboxylase （GAD） were negative，insulin autoantibody （IAA） was positive in ten cases.At the same time，the serum insulin levels were significantly increased and inconsistent with C-peptide level.Eight patients stopped insulin treatment，six of whom changed to oral hypoglycemic drugs，one was given intravenous infusion of Methylpredation because of coma after hypoglycemia and one changed diet.The other two patients were replaced with the insulin dosage form and added with Butanpine at the same time.No hypoglycemia occurred in ten patients from 2 weeks to 5 months after treatment.Conclusion　Diabetic patients with long-term insulin use have recurrent episodes，severe spontaneous hypoglycemia，and significantly increased insulin levels，which are inconsistent with C-peptide level.When IAA is positive，the diagnosis of EIAS should be considered.They should stop using insulin，or change insulin dosage form，and severe patients should be given glucocorticoid therapy.Patients with EIAS have a good prognosis.

Key words: Exogenous insulin autoimmune syndrome, Immunological, Insulin, Autoantibodies