A rare case of autoimmune dysglycemia syndrome associated with systemic lupus erythematosus and dermatomyositis

Autoimmune dysglycemia syndrome (ADS) is a rare condition that presents as episodes of hypoglycemia well hyperglycemia and classified insulin autoimmune (IAS) type B resistance (TBIR). Autoimmunity plays key role in the pathogenesis this disorder, evidenced by presence autoantibodies against endogenous or receptor, its association with rheumatologic disorders. Treatment usually includes glycemic control immunomodulatory agents. We report case 31-year-old woman who was admitted for severe hypoglycemia. Further workup revealed underlying systemic lupus erythematosus (SLE) renal involvement. During hospitalization, she continued to experience fasting hypoglycemia, postprandial hyperglycemia. Hypoglycemia associated high serum concentration positive anti-insulin antibodies were consistent IAS. Likewise, weight loss, acanthosis nigricans, polycystic ovarian syndrome, normotriglyceridemia strongly suggested TBIR, although testing receptor not available Peru. Immunosuppressive therapy metformin indicated, resulting remission SLE ADS. Years later, patient exhibited features dermatomyositis, such Raynaud’s phenomenon, muscular weakness, heliotrope exanthema, elevated muscle enzymes. Once again, received immunosuppressive therapy. ADS an infrequent cause coexistence two pathophysiological mechanisms subsequent development dermatomyositis even more rare. Our first one reported describing association.