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Related Experiment Videos

[Delayed hypersensitivity to protamine and immediate hypersensitivity to insulin].

A Köllner1, H Senff, L Engelmann

  • 1Klinik für Dermatologie und Allergologie, St.-Barbara-Hospital Duisburg.

Deutsche Medizinische Wochenschrift (1946)
|August 16, 1991
PubMed
Summary

This study details a patient experiencing allergic reactions to insulin injections, first to protamine (type IV hypersensitivity) then to human insulin (type I hypersensitivity). Immunological investigation is crucial for managing insulin allergy.

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Area of Science:

  • Endocrinology
  • Immunology
  • Dermatology

Background:

  • Type II diabetes mellitus management often involves insulin therapy.
  • Combination therapy with sulfonylureas and depot insulin is used for inadequate glycemic control.
  • Insulin injections can precipitate localized skin reactions.

Observation:

  • A patient developed nodular skin reactions at insulin injection sites within 3 months of starting combination therapy.
  • Intradermal testing revealed delayed-type (Gell and Coombs type IV) hypersensitivity to protamine.
  • Subsequent immediate-type (Gell and Coombs type I) hypersensitivity to human insulin manifested as urticarial lesions.

Findings:

  • The patient exhibited distinct hypersensitivity reactions to different components of insulin preparations.

Related Experiment Videos

  • Protamine-induced delayed hypersensitivity and human insulin-induced immediate hypersensitivity were identified.
  • No specific IgE or IgG antibodies were detected, highlighting the complexity of insulin allergy diagnosis.

    • Implications:

    • Accurate immunological investigation is essential for diagnosing and managing insulin hypersensitivity.
    • Switching to protamine-free insulin formulations can alter the type of allergic reaction.
    • Prompt identification and management of insulin allergy ensure patient safety and treatment efficacy.