Karimzadeh Sana, Andrade Lopes Stéphanie, Allali Danièle, Nigolian Haïg, Jornayvaz François R, Gariani Karim
Service de médecine de premier recours, Département de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14.
Service d'endocrinologie, diabétologie, nutrition et éducation thérapeutique du patient, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
Rev Med Suisse. 2022 Jun 1;18(784):1100-1105. doi: 10.53738/REVMED.2022.18.784.1100.
Insulin allergy is a rare entity, complex to manage. Several types of hypersensitivity reaction are described, depending on the allergens (insulin itself vs additives). Type I, so-called immediate, IgE-mediated reactions are the most common. Their management requires a careful history and examination, as well as an allergological consult. If an IgE-mediated allergy is confirmed, insulin avoidance is recommended whenever possible. If insulin treatment is mandatory, another type of insulin may be offered. In case of failure, desensitization should be discussed, either via a dedicated protocol, or via insulin pump. In this article, we summarize the available data from the literature.
胰岛素过敏是一种罕见且难以处理的情况。根据过敏原(胰岛素本身与添加剂)的不同,可描述出几种类型的超敏反应。I型,即所谓的速发型、IgE介导的反应最为常见。其处理需要详细的病史和检查,以及过敏科会诊。如果确诊为IgE介导的过敏,建议尽可能避免使用胰岛素。如果必须进行胰岛素治疗,可以换用其他类型的胰岛素。若治疗失败,应讨论脱敏治疗,可通过专门的方案或胰岛素泵进行。在本文中,我们总结了文献中的现有数据。