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Type I Hypersensitivity: case report A 61-year-old woman developed type I hypersensitivity during treatment with insulin-aspart and insulin-detemir for insulindependent type 2 diabetes mellitus [routes; dosages and outcome not stated]. The woman who had insulin-dependent type 2 diabetes mellitus from the past 30 years presented to the emergency department for the evaluation of insulin reaction. Over the 5months, she experienced 2 episoded of hypersensitivity reactions. On the first episode, she experienced pruritus of the extremities and nausea, immediately after injecting insulin-aspart [NovoRapid insulin]. Moreover, she also experienced respiratory distress, angioedema and hypotension, on an immediate basis, after injecting insulindetemir [Detemir] and insulin-aspart. She also received metformin. The woman underwent a skin testing as per published testing concentrations, with metformin, insulin-glargine [Lantus], insulinlispro [Humalog], insulin-aspart, insulin-glulisine [glulisine], insulin [insulin Regular], insulin-suspension-isophane [NPH], insulindetemir and the excipient protamine-sulfate [protamine]. A negative testing also performed with protamine-sulfate, but, sensitization to all insulin preparations was found. A negative result were revealed by metformin skin test and challenge along with latex IgE. She declined a challenge with insulin and was recommended insulin desensitization, which was followed by use of an insulin pump. Aberumand B, et al. An uncommon case of insulin allergy. Allergy, Asthma and Clinical Immunology 16 (Suppl. 1): 4-5 abstr. 10, Jan 2020. Available from: URL: http:// 803515059 doi.org/10.1186/s13223-020-00445-x [abstract]

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Reactions 14 Nov 2020 No. 1830