title: Immediate-type allergy against insulin itself: clinical and immunologic studies on a diabetic patient with insulin intolerance.
abstract: In this report clinical and immunologic data of a female diabetic patient with immediate-type allergy against insulin preparations of different species, including pancreatic human insulin, biosynthetic human insulin and semisynthetic human insulin are described. The determination of insulin-specific antibodies showed relatively high IgE-antibody titers in contrast to low IgG-antibody concentrations, which is in accordance with the assumption that the ratio of IgE- to IgG-insulin antibodies is important in the outcome of clinically manifest allergic reactions. Negative results for cutaneous delayed-type insulin hypersensitivity and for stimulation of lymphocyte blastogenesis exclude type IV immunopathogenic reaction in this insulin-allergic patient. Preliminary data suggest that inherited individual factors--such as DR2, DR3 positivity in this diabetic individual--might predispose diabetic patients to insulin allergy.
mesh_terms: D000368:Aged; D000818:Animals; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D007330:Insulin Antibodies; D008213:Lymphocyte Activation / Q000187:drug effects; D012882:Skin Tests; D013045:Species Specificity; D013552:Swine
chemical_list: D007328:Insulin; D007330:Insulin Antibodies