Treatment by Plasma Exchange of a Patient with Autoantibodies to the Insulin Receptor

Abstract

WE recently described two groups of patients with severe insulin-resistant diabetes and acanthosis nigricans.¹ In these patients the defect of insulin action could be correlated with markedly abnormal binding of insulin to the insulin receptor, and in one group (Type B) this binding was due to circulating antibodies to the insulin-receptor that impaired receptor function.^{1 2 3} These anti-receptor antibodies have been extensively characterized.^{3 4 5 6} The clinical course of these patients has been variable, ranging from spontaneous remission to death due to hypoglycemia.⁷ Some patients have responded to immunosuppressive therapy.⁸ In this paper, we report the effect of plasma exchange in a patient . . .