Advantage of insulin lispro in suspected insulin allergy

Abstract

an elimination-challenge procedure. The patient ful®lled all the diagnostic criteria of FIE (1, 5): vomiting and/or diarrhea occurring within 24 h of the challenge, stool containing blood and leukocytes, and a rise in PNL of .3500/mm 3 . We also observed a rise in the eosinophil count.Although the clinical picture in our patient seems to be clear, the mechanism remains obscure. As the target organ was the gastrointestinal tract, we think that the cow's milk antigens probably present in the amniotic¯uid might have been responsible.

Allergic reactions to human insulin: a review of current knowledge and treatment options

“…Rapid-acting insulin analogues revealed with an immediate dissociation of hexamer structure to monomers, so that they might be less antigenic [38,39]. Successful treatment of local and systemic insulin allergy has been reported with switching of insulin treatment to a rapidacting insulin analogue, namely insulin lispro [40][41][42][43], aspart [44,45] or glulisine [46]. In a series of 22 patients with insulin allergy, Bodtger et al [12] reported five patients treated with insulin analogues, of those three had full and two had partial remission.…”

A rational clinical approach to suspected insulin allergy: status after five years and 22 cases

“…Allergic reactions during human recombinant (rDNA) insulin therapy have been reported in several cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The insulin preparation (IP) contains multiple potential allergens: insulin, carrier proteins, and additives [15].…”

Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report

“…Therefore, because rapid-acting insulin analogs are rapidly dissociated into monomers, they may be less likely to induce allergy. 3 This theory was supported by multiple case reports that demonstrated successful management of insulin allergy by transitioning to the rapid-acting agents insulin lispro, [25][26][27][28] insulin aspart, 29,30 or insulin glulisine. 31 Conversely, Hara et al 18 proposed that the longacting analog insulin glargine might actually be less antigenic than other analogs, and its slow dissolution could mimic a desensitization process.…”