INS and plasma cell myeloma: The patient, a 78-year-old man, presented with fasting and late postprandial hypoglycemia and markedly elevated levels of immunoreactive insulin.8 High titers of insulin antibodies were observed and an insulin autoimmune syndrome diagnosed, but during the medical evaluation a monoclonal IgG-kappa (2.2 g/dL) secreting myeloma was found.