Insulin
- PDF / 141,586 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 33 Downloads / 202 Views
1
Insulin Allergy and immunological insulin resistance associated with a paraneoplastic syndrome: case report A 62-year-old man developed insulin allergy and immunological insulin resistance associated with a paraneoplastic syndrome. Three months after starting treatment with insulin aspart/ insulin protamine aspart [dosage not stated] for type 2 diabetes mellitus, the man developed urticariform erythema and induration at insulin injection sites. The erythema developed immediately after insulin administration and lasted for approximately 20 minutes; the induration lasted for 3–4 days. He was subsequently diagnosed with lung cancer. Laboratory investigations revealed elevated serum insulin levels associated with high IgG anti-insulin antibodies; human insulin-specific IgE was also elevated. His glucose levels were poorly controlled despite administration of insulin aspart and subsequent treatment with mitiglinide and voglibose. Investigations also revealed an elevated plasma interleukin (IL)-6 level of 96.4 pg/mL. The man received antineoplastic therapy with carboplatin and docetaxel and his lung tumour decreased in size. After 3 weeks, his blood glucose levels had improved to 5.1–11.9 mmol/L and his insulin IgG antibody, fasting serum insulin and human insulin-specific IgE antibody levels had decreased. In addition, his plasma IL-6 level had decreased to 8 pg/mL. Author comment: "[M]ultiple immune responses to insulin, including immediate allergy, delayed cutaneous hypersensitivity, and immunologic insulin resistance, were thought to have occurred as a paraneoplastic syndrome based on IL-6 secretion by lung cancer." Mizuhashi S, et al. Insulin allergy and immunologic insulin resistance caused by interleukin-6 in a patient with lung cancer. Diabetes Care 29: 1711-1712, No. 7, 801041560 Jul 2006 - Japan
0114-9954/10/1110-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Jul 2006 No. 1110
Data Loading...
