1型糖尿病患者因迟发型胰岛素过敏导致胆囊水肿。

Gallbladder edema in type 1 diabetic patient due to delayed-type insulin allergy.

作者信息

Kawasaki Fumiko, Kamei Shinji, Tatsumi Fuminori, Hamamoto Sumiko, Shimoda Masashi, Tawaramoto Kazuhito, Shigeto Makoto, Kanda Yukiko, Hashiramoto Mitsuru, Matsuki Michihiro, Kaku Kohei

机构信息

Division of Diabetes and Endocrinology, Department of Medicine, Kawasaki Medical School, Kurashiki.

出版信息

Intern Med. 2009;48(17):1545-9. doi: 10.2169/internalmedicine.48.2353. Epub 2009 Sep 1.

DOI:10.2169/internalmedicine.48.2353

PMID:19721301

Abstract

A 29-year-old woman was diagnosed as having type 1 diabetes mellitus and received insulin aspart and NPH insulin (NovolinN). On day 22, she had leg edema and right abdominal pain. The serum hepatobiliary enzyme levels were markedly elevated. Computed tomography revealed gallbladder edema. After an injection of human regular insulin and NPH insulin (HumacartN), the elevated liver enzyme levels were no longer observed. Challenge testing demonstrated that protamine was the cause of her allergy. Furthermore, tests revealed increased VEGF levels. This is an extremely rare case with a delayed-type protamine allergy caused by NovolinN resulting in gallbladder edema.

摘要

一名29岁女性被诊断为1型糖尿病，接受门冬胰岛素和精蛋白生物合成人胰岛素（诺和灵N）治疗。在第22天，她出现腿部水肿和右上腹疼痛。血清肝胆酶水平显著升高。计算机断层扫描显示胆囊水肿。在注射人常规胰岛素和精蛋白生物合成人胰岛素（优泌林N）后，未再观察到肝酶水平升高。激发试验表明鱼精蛋白是其过敏的原因。此外，检测显示血管内皮生长因子水平升高。这是一例极为罕见的由诺和灵N引起的迟发型鱼精蛋白过敏导致胆囊水肿的病例。