Yamagishi S, Abe T, Sawada T
Department of Internal Medicine, Kanazawa Municipal Hospital, Japan.
Horm Res. 1995;43(6):300-2. doi: 10.1159/000184354.
A case of newly diagnosed non-insulin-dependent diabetes mellitus with immediate-type allergy against semisynthetic human insulin is reported. She experienced immediate-type allergy 2 months after initial insulin treatment. A skin test showed that she had allergy against the insulin itself but not the additives. The amino acid sequence of the semisynthetic human insulin was identical to that of endogenous native insulin and, moreover, the patient had not been treated with animal-derived insulin previously, so a structural change to the semisynthetic formulation at the injected subcutaneous site might have antigenicity. An H1 histamine blocker markedly diminished the skin reaction to insulin, and her plasma glucose and glycosylated hemoglobin AIc became well controlled. In summary, we experienced a diabetic patient with human insulin allergy at the time of initial insulin treatment, emphasizing that the possibility of human insulin allergy should be considered whenever a patient is started on insulin therapy.
报告了一例新诊断的非胰岛素依赖型糖尿病患者，其对半合成人胰岛素存在速发型过敏反应。她在初始胰岛素治疗2个月后出现速发型过敏反应。皮肤试验表明，她对胰岛素本身过敏，而非对添加剂过敏。半合成人胰岛素的氨基酸序列与内源性天然胰岛素相同，此外，该患者此前未接受过动物源性胰岛素治疗，因此在注射皮下部位的半合成制剂的结构变化可能具有抗原性。一种H1组胺阻滞剂显著减轻了对胰岛素的皮肤反应，并且她的血浆葡萄糖和糖化血红蛋白A1c得到了良好控制。总之，我们遇到了一名在初始胰岛素治疗时出现人胰岛素过敏的糖尿病患者，强调在任何患者开始胰岛素治疗时都应考虑人胰岛素过敏的可能性。
