title: Gallbladder edema in type 1 diabetic patient due to delayed-type insulin allergy.
abstract: A 29-year-old woman was diagnosed as having type 1 diabetes mellitus and received insulin aspart and NPH insulin (NovolinN). On day 22, she had leg edema and right abdominal pain. The serum hepatobiliary enzyme levels were markedly elevated. Computed tomography revealed gallbladder edema. After an injection of human regular insulin and NPH insulin (HumacartN), the elevated liver enzyme levels were no longer observed. Challenge testing demonstrated that protamine was the cause of her allergy. Furthermore, tests revealed increased VEGF levels. This is an extremely rare case with a delayed-type protamine allergy caused by NovolinN resulting in gallbladder edema.
authors.affiliation: Division of Diabetes and Endocrinology, Department of Medicine, Kawasaki Medical School, Kurashiki. fumiko@med.kawasaki-m.ac.jp
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kawasaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Kamei
authors.forename: Fuminori
authors.initials: F
authors.lastname: Tatsumi
authors.forename: Sumiko
authors.initials: S
authors.lastname: Hamamoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Shimoda
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Tawaramoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Shigeto
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanda
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Hashiramoto
authors.forename: Michihiro
authors.initials: M
authors.lastname: Matsuki
authors.forename: Kohei
authors.initials: K
authors.lastname: Kaku
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000150:complications / Q000175:diagnosis*; D007328:Insulin / Q000009:adverse effects*
chemical_list: D007328:Insulin