BACKGROUND Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia and is characterized by the presence of insulin autoantibodies. Patients with IAS usually complain of hypoglycemia without any previous insulin received. Glucocorticoids and immunosuppressants are used to treat IAS. CASE PRESENTATION We report four patients with diabetes who were diagnosed with non-classical IAS and describe the treatment of these patients. Moreover, the differential diagnosis with hyperinsulinism is discussed. CONCLUSION High levels of insulin autoantibodies, as well as hyperinsulinemic hypoglycemia, are found in patients with diabetes mellitus and prior exogenous insulin exposure. This situation that we classified as non-classical IAS should be attached importance to.

中文翻译：

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外源性胰岛素注射引起的胰岛素自身免疫综合症：四例系列。

背景技术胰岛素自身免疫综合症（IAS）是低血糖的罕见原因，其特征在于存在胰岛素自身抗体。IAS患者通常抱怨血糖过低，而以前未接受任何胰岛素治疗。糖皮质激素和免疫抑制剂可用于治疗IAS。病例介绍我们报告了四例被诊断为非经典IAS的糖尿病患者，并描述了这些患者的治疗方法。此外，讨论了高胰岛素血症的鉴别诊断。结论在患有糖尿病和先前外源性胰岛素暴露的患者中发现了高水平的胰岛素自身抗体以及高胰岛素低血糖症。我们应将这种情况分类为非经典IAS。