Clopidogrel-induced insulin autoimmune syndrome: A case report and analysis of clinical characteristics in Chinese patients

Clopidogrel-induced insulin autoimmune syndrome is a rare condition that typically presents with hypoglycemic symptoms, making clinical recognition challenging and often leading to misdiagnosis or underrecognition as a drug-related adverse event. Systematic analyses of clopidogrel-induced insulin autoimmune syndrome in the Chinese population remain limited. This report describes a 69-year-old Chinese man who developed insulin autoimmune syndrome following clopidogrel administration. His condition improved after clopidogrel discontinuation, switching to ticagrelor, dietary modification, and treatment with voglibose. Additionally, published cases of clopidogrel-associated insulin autoimmune syndrome in the Chinese population were systematically retrieved from PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang databases up to October 2025. The clinical characteristics of clopidogrel-associated insulin autoimmune syndrome in the Chinese population were summarized. Cases involving patients from other countries were also included for comparison to identify similarities and differences in disease characteristics between Chinese and non-Chinese populations. This study aimed to provide a reference for the early clinical recognition and individualized diagnosis and treatment of this condition.