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Hirata’s disease (insulin autoimmune syndrome) following envenomation by a common krait

Senthilkumaran, S., Miller, S. W., Williams, H. F., Thirumalaikolundusubramanian, P., Vaiyapuri, S. ORCID: and Patel, K. (2022) Hirata’s disease (insulin autoimmune syndrome) following envenomation by a common krait. Toxicon, 219. 106923. ISSN 0041-0101

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To link to this item DOI: 10.1016/j.toxicon.2022.09.009


Snakebite envenomation is known to cause local as well as systemic haematological, myotoxic and neurological effects. Adverse effects on the endocrine system following envenomation are rarely reported. Hirata’s disease, also known as insulin autoimmune syndrome (IAS) is a rare disorder that causes hypoglycaemia due to excessive production of insulin autoantibodies. This report describes a rare case of IAS which developed in a snakebite victim following envenomation by a common krait and antivenom treatment. The patient was initially treated with dextrose and corticosteroids, although plasmapheresis was required to reduce the concentration of insulin antibodies and normalise the patient’s glucose level. The patient then made an uneventful recovery without permanent sequelae. This report demonstrates the impacts of envenomation by a common krait on developing Hirata’s disease and creates awareness among clinicians who treat snakebite envenomation.

Item Type:Article
Divisions:Life Sciences > School of Biological Sciences > Biomedical Sciences
Life Sciences > School of Chemistry, Food and Pharmacy > School of Pharmacy > Division of Pharmacology
ID Code:107350


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