title: Primary systemic allergy to human insulin: recurrence of generalized urticaria after successful desensitization.
abstract: Primary systemic allergy to human insulin is rare. We report a case of recurrent immediate local reactions followed eventually by generalized urticaria to recombinant human insulin (Humulin) in an insulin-dependent diabetic. Skin test to Humulin R was positive, and the patient was successfully desensitized using a modified rapid desensitization protocol. Two weeks later, he had another episode of generalized urticaria after Humulin R injection. His treatment was resumed at a lower dose, and within a week he was able to tolerate his usual regimen of insulin. To our knowledge, this is the first report of a recurrence of systemic reaction after successful desensitization.
authors.affiliation: Department of Rheumatology, Tan Tock Seng Hospital, Singapore.
authors.forename: H H
authors.initials: HH
authors.lastname: Chng
authors.forename: K P
authors.initials: KP
authors.lastname: Leong
authors.forename: K C
authors.initials: KC
authors.lastname: Loh
mesh_terms: D000328:Adult; D003888:Desensitization, Immunologic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D006801:Humans; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D012008:Recurrence; D012846:Singapore; D012882:Skin Tests; D014581:Urticaria / Q000209:etiology* / Q000276:immunology / Q000628:therapy
chemical_list: D007328:Insulin