Anaphylaxis and immunologic insulin resistance in a diabetic woman with ketoacidosis.

Abstract:

:A diabetic woman presented with diabetic ketoacidosis after demonstrating immediate-type hypersensitivity to heterologous insulin. She had had interrupted insulin therapy in the past. Insulin requirements during the course of treatment for the acidosis suggested marked resistance, with 50,000 U of insulin needed in the first 36 h. Anaphylaxis requiring intubation and emergency treatment developed after intravenous purified pork insulin was administered. Elevated titers of insulin-specific IgG (441.6 U/L serum) demonstrated immunologic insulin resistance. Positive intradermal skin tests for beef and pork insulins and detection of insulin-specific IgE by RAST assay revealed concurrent immediate-type allergy. A review of the literature revealed the unique occurrence in this patient of simultaneous ketoacidosis, insulin allergy, anaphylaxis, and immunologic resistance. Interrupted insulin therapy in susceptible individuals remains a potential danger, even with the availability of purified insulin preparations.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Ross JM,Murali MR,DeLara TC,Cheron RG

doi

10.2337/diacare.7.3.276

subject

Has Abstract

pub_date

1984-05-01 00:00:00

pages

276-9

issue

3

eissn

0149-5992

issn

1935-5548

journal_volume

7

pub_type

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