Abstract

BACKGROUND
Insulin allergy is a not uncommon condition even though human insulin and insulin analogues are widely used. However, the development of insulin allergy after bone marrow transplantation has not been reported.
CASE REPORT
A 44-year-old Japanese woman had aplastic anaemia and secondary haemochromatosis. She was diagnosed with having diabetes at age 32 years and had been treated with human insulin. At age 34 years, bone marrow transplantation was performed. One year later, a rash and urticaria appeared immediately after insulin injections. Intracutaneous tests were positive for both human insulins and analogues, whereas the test for protamine was negative. Furthermore, an IgE-radioallergosorbent test against insulin was positive. Thus, we diagnosed the patient with having an IgE-mediated type I allergy against insulin. Insulin therapy with insulin aspart, which showed the least skin reaction, was continued and the insulin allergy disappeared in 7 years.
CONCLUSIONS
This is the first description of insulin allergy after bone marrow transplantation. Our case underscores the effects of bone marrow cells on IgE-mediated type I allergy for insulin.

Links

Publisher Full Text

Authors

Yoshida N, Okubo M, Ishiguro K, Mori Y

Institution

Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.

Source

Diabetic medicine : a journal of the British Diabetic Association 29:10 2012 Oct pg 1339-41

MeSH

Adult
Bone Marrow Transplantation
Drug Eruptions
Drug Hypersensitivity
Female
Graft vs Host Reaction
Humans
Hypoglycemic Agents
Immunoglobulin E
Injections, Subcutaneous
Insulin
Insulin Aspart
Radioallergosorbent Test
Urticaria

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22587424