de Maat-Bleeker F, van Vloten W A, de Maat C E
Academisch Ziekenhuis, afd. Dermatologie-Allergologie, Utrecht.
Ned Tijdschr Geneeskd. 1994 Nov 5;138(45):2256-9.
In two patients, a man aged 55 years (patient A) and a man aged 67 years (patient B), severe immediate (type I) and severe delayed (type IV) local reactions to injections of human insulin, respectively, were diagnosed. There had been no previous treatment with insulin of animal origin. The diagnosis of type I allergy was based on the typical early local reaction with biphasic course, the positive immediate skin test and the raised specific IgE level against insulin. The diagnosis of type IV allergy was based on the characteristic late local reaction after 12 hrs, the delayed positive skin test and the negative specific IgE. The first attempt to desensitise patient A in 10 days was not successful, but he was desensitised successfully in 25 days. Patient B recovered spontaneously.
在两名患者中，分别诊断出对注射人胰岛素的严重即刻（I型）和严重延迟（IV型）局部反应。一名55岁男性患者（患者A），另一名67岁男性患者（患者B）。此前均未接受过动物源性胰岛素治疗。I型过敏的诊断基于典型的早期局部反应（呈双相病程）、即刻皮肤试验阳性以及针对胰岛素的特异性IgE水平升高。IV型过敏的诊断基于12小时后出现的特征性晚期局部反应、延迟性皮肤试验阳性以及特异性IgE阴性。对患者A进行的首次脱敏尝试在10天内未成功，但在25天时成功脱敏。患者B自行康复。
