title: Type 1 Ig-E mediated allergy to human insulin, insulin analogues and beta-lactam antibiotics.
abstract: Insulin, a crucial therapeutic agent for diabetes mellitus, has been rarely associated with hypersensitivity events. We present a 69-year-old type-2 diabetic patient with urticariform lesions on the sites of subcutaneous injection of insulin. The patient denied any known allergies, except for an unspecific cutaneous reaction after intramuscular penicillin administration in childhood. Prick tests revealed positive reactions to all tested human insulins and insulin analogues. Serum IgE levels were above normal range and RAST tests were positive for human, bovine and porcine insulins, as well as beta-lactams. Type 1 IgE-mediated allergy to insulin analogues demands a prompt diagnosis and represents a significant therapeutic challenge in diabetic patients.
authors.affiliation: Dermatology and Venereology Service, Teaching Hospitals of University of Coimbra (Universidade de Coimbra, EPE) - Coimbra, Portugal. pedro.andrade@portugalmail.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Andrade
authors.forename: Luísa
authors.initials: L
authors.lastname: Barros
authors.forename: Margarida
authors.initials: M
authors.lastname: Gonçalo
mesh_terms: D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002417:Cattle; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007073:Immunoglobulin E / Q000276:immunology*; D061268:Insulin Lispro / Q000009:adverse effects*; D008297:Male; D012882:Skin Tests / Q000379:methods; D013552:Swine; D047090:beta-Lactams / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D007004:Hypoglycemic Agents; D061268:Insulin Lispro; D047090:beta-Lactams; D007073:Immunoglobulin E