Immediate-Type Allergy against Human Insulin Associated with Marked Eosinophilia in Type 2 Diabetic Patient.

Nagai, Yukihiro; Mori, Toshifumi; Abe, Toshio; Nomura, Gakuji

doi:10.1507/endocrj.48.311

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…Insulin allergy with marked eosinophilia has been reported to accompany the elevation of specific IgE for human insulin (13). However, in the present case, we could not detect total IgE elevation or specific IgE for human insulin.…”

Section: Discussioncontrasting

confidence: 91%

Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia

et al. 2015

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A 66-year-old man with type 2 diabetes on hemodialysis treatment was admitted due to poor glycemic control. His serum insulin level and the 125 I-insulin binding rate were extremely high with an increased eosinophil count, although he did not have an allergic reaction to insulin or an elevation of specific IgE for human insulin. A Scatchard analysis revealed that the patient's insulin antibodies had a low affinity constant and a high binding capacity. Prednisolone administration decreased the eosinophil count and 125 I-insulin binding rate; accordingly, the glycemic control improved. Corticosteroid therapy may be a potent therapeutic strategy for insulin antibody-induced severe insulin resistance with eosinophilia.

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Section: Discussioncontrasting

confidence: 91%

Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia

et al. 2015

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“…Other Tcell-mediated syndromes associated with eosinophilia include L-tryptophan syndrome (eosinophilia-myalgia syndrome) and the Spanish toxic oil syndrome [12]. IgE-mediated reactions associated with eosinophilia also have been described with drugs such as penicillin and insulin [13].…”

Section: Drugsmentioning

confidence: 99%

Eosinophilic Disorders in Various Diseases

Celestin

Frieri

2011

Curr Allergy Asthma Rep

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Peripheral and tissue eosinophilia are usually associated with a variety of inflammatory, malignant, and infectious conditions. As the presence of eosinophils in the tissues may cause significant cellular damage to vital organs such as the heart, tissue eosinophilia should be diagnosed and treated promptly. One operative way to evaluate eosinophilic disorders is to classify them into extrinsic and intrinsic. While extrinsic eosinophilic disorders are usually due to the production of eosinopoietic factors derived from T cells or tumor cells, the intrinsic types generally are the result of genetic mutations in the eosinophilic lineage. As we understand more the biology of eosinophils, only a few eosinophilic disorders remain idiopathic. The purpose of this article is to help the clinician classify in an operational manner most eosinophilic disorders, using the extrinsic and intrinsic model. This may facilitate not only a better understanding of the role of eosinophils in these disorders, but also help the systematic clinical work-up and potential treatment of affected patients.

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“…insulin allergy, especially at the initiation of insulin therapy [1]. Thus, only a few case reports on immediatetype allergies against human insulin have been published in the literature [1].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan

Minakawa¹,

Kaneko²,

Fukui³

et al. 2014

CRCM

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We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.

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Immediate-Type Allergy against Human Insulin Associated with Marked Eosinophilia in Type 2 Diabetic Patient.

Cited by 11 publications

References 15 publications

Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia

Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia

Eosinophilic Disorders in Various Diseases

Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan

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