title: Delayed-type hypersensitivity reaction to the meta-cresol component of insulin.
abstract: BACKGROUND
  Reactions to recombinant human insulin preparations occur at a rate of 2.4%. Although most have been traced to immunological reactions to the insulin, recent reports suggest that some adverse reactions can occur to the nonmedicinal excipients or preservatives of commercially available insulin preparations.
  
  
  OBJECTIVE
  To investigate a localized delayed cutaneous reaction to human insulin.
  
  
  METHODS
  Intradermal and patch testing were performed on a patient to evaluate sensitivity to commercial human insulins, meta-cresol, and other sensitizers.
  
  
  RESULTS
  Patch test results were positive to the meta-cresol preservative.
  
  
  CONCLUSIONS
  This is the first report, to our knowledge, of a reaction to meta-cresol in commercial preparations of insulin. This reaction should be considered in the differential diagnosis of adverse reactions to insulin injections.
authors: Division of Rheumatology, Immunology, and Allergy, Georgetown University, Washington, DC 20007-2197, USA. baraniuj@georgetown.edu
authors: Dennis
authors: D
authors: Kim
authors: James
authors: J
authors: Baraniuk
mesh_terms: D003408:Cresols / Q000009:adverse effects*; D048909:Diabetes Complications / Q000139:chemically induced* / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced* / Q000175:diagnosis; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000737:chemistry; D007277:Injections, Jet; D007328:Insulin / Q000008:administration & dosage* / Q000737:chemistry; D008875:Middle Aged; D010328:Patch Tests
chemical_list: D003408:Cresols; D007004:Hypoglycemic Agents; D007328:Insulin; C042041:3-cresol