Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium.
IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
Contact Dermatitis. 2019 Dec;81(6):432-437. doi: 10.1111/cod.13374. Epub 2019 Aug 27.
The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens.
To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set.
Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed.
Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set.
IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.
FreeStyle Libre 葡萄糖传感器已导致许多过敏接触性皮炎病例,而该传感器中的异冰片丙烯酸酯(IBOA)已被确定为其中一种致敏原。
报告美敦力生产的设备中存在 IBOA,即 Enlite 传感器和胰岛素输注套件 Paradigm MiniMed Quick-set。
在三个诊所(两个比利时和一个瑞典)观察到对葡萄糖传感器 Enlite 和/或胰岛素输注套件 Paradigm MiniMed Quick-set 产生反应的五名患者,用基线和其他系列,以及 IBOA 进行斑贴试验;其中四人还使用了设备上的粘片,两人使用了 Enlite 葡萄糖传感器提取物的薄层色谱法。进行了气相色谱-质谱(GC-MS)分析。
四名患者对 IBOA 和已知存在于 Enlite 中的过敏原松香酸产生反应,三名患者对传感器或胰岛素输注套件的粘性部分产生反应。GC-MS 鉴定了传感器中的 IBOA,并表明输注套件中存在 IBOA。
IBOA 是 Enlite 葡萄糖传感器中的一种接触过敏原,并且很可能也是输注套件中的过敏原。因此,对于对 FreeStyle Libre 传感器过敏的患者,这些设备不适合替代。