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Immediate-Type Allergy Against Insulin Itself: Clinical and Immunologic Studies on a Diabetic Patient with Insulin Intolerance

  1. G Schernthaner,
  2. H Ludwig,
  3. R Jarisch and
  4. H Bruneder
  1. Department of Medicine II, Department of Dermatology I, University of Vienna, the Ludwig Boltzmann-Institute for Clinical Endocrinology, and the Outpatient Department for Diabetics of GKK Vienna, Austria
  1. Address reprint requests to G. Schernthaner, M.D., Diabetes Research Group, Department of Medicine II, University of Vienna, Garnisongasse 13, A-1090, Vienna, Austria.

Abstract

In this report clinical and immunologic data of a female diabetic patient with immediate-type allergy against insulin preparations of different species, including pancreatic human insulin, biosynthetic human insulin and semisynthetic human insulin are described. The determination of insulin-specific antibodies showed relatively high IgE-antibody titers in contrast to low IgG-antibody concentrations, which is in accordance with the assumption that the ratio of IgE- to IgG-insulin antibodies is important in the outcome of clinically manifest allergic reactions. Negative results for cutaneous delayed-type insulin hypersensitivity and for stimulation of lymphocyte blastogenesis exclude type IV immunopathogenic reaction in this insulin-allergic patient. Preliminary data suggest that inherited individual factors–such as DR2, DR3 positivity in this diabetic individual–might predispose diabetic patients to insulin allergy.

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