Type B Insulin Resistance Associated with Systemic Lupus Erythematosus: A Case Report

Resistencia a la insulina tipo B asociado a Lupus Eritematoso Sistémico: Reporte de Caso

Abstract

A 36-year-old woman presented with a two-year history of irritability, confusion, and predominantly morning fainting spells that resolved after eating. In recent months, she developed lower extremity edema and intermittent foamy urine. Physical examination revealed pallor, madarosis, acanthosis nigricans, edema of the fingers and lower extremities, and Raynaud's phenomenon. Laboratory results showed fasting glucose 65 mg/dL, insulin 11 µIU/mL, cortisol 11.9 µg/dL, lymphocytes 299 cells/mm³, and hemoglobin 11.2 g/dL. ANA was 1/320, and ENA profile showed RPN/Sm: high positive, Sm: positive. Fasting test (38 hours): glucose 41 mg/dL, C-peptide 0.1 ng/dL, insulin 1.9 µIU/mL, cortisol 19.3 µg/dL, GH 3.0 µg/L. The patient received high-dose corticosteroid therapy and hydroxychloroquine for the management of autoimmune diseases; no new episodes of hypoglycemia were reported.