We report a
64-year-old female patient with an insulin allergy. She was treated with a
combination of oral antihistamines, topical hydrocortisone cream, and moisturizing
agents, which resulted in the improvement of eczema and intense pruritus. To
evaluate insulin allergy, intradermal skin tests were performed with several
insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic
human insulin resulted in local, immediate skin reactions such as itchy
erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of
insulin allergy previously reported in the literature as far as we know.
Interestingly, the number of male patients was approximately two times higher
than that of female, and the insulin-specific IgE antibody test was positive in
21 patients. We should keep the possibility of human insulin allergy in mind
and prepare for it when initiating human insulin therapy.
Cite this paper
Minakawa, S. , Kaneko, T. , Fukui, T. , Sakuraba, Y. , Aizu, T. , Korekawa, A. , Takiyoshi, N. , Rokunohe, A. , Moriyama, T. and Sawamura, D. (2014) Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan. Case Reports in Clinical Medicine
, 496-499. doi: 10.4236/crcm.2014.38108
 Nagai, Y., Mori, T., Abe, T. and Nomura, G. (2001) Immediate-Type Allergy with Marked Eosinophilia against in Type Human Insulin Associated 2 Diabetic Patient. Endocrine Journal, 48, 311-316. http://dx.doi.org/10.1507/endocrj.48.311
 Ganz, M.A., Unterman, T., Roberts, M., Uy, R., Sahgal, S., Samter, M. and Grammer, L.C. (1990) Resistance and Allergy to Recombinant Human Insulin. Journal of Allergy and Clinical Immunology, 86, 45-51. http://dx.doi.org/10.1016/S0091-6749(05)80122-8
 Granic, M., Renar, I.P., Metelko, Z. and Skrabalo, Z. (1986) Insulin Allergy. Diabetes Care, 9, 99-100.
 Grammer, L.C., Roberts, M., Buchanan, T.A., Fitzsimons, R., Metzger, B.E. and Patterson, R. (1987) Specificity of Immunoglobulin E and Immunoglobulin G against Human (Recombinant DNA) Insulin in Human Insulin Allergy and Resistance. Journal of Laboratory and Clinical Medicine, 109, 141-146.
 Balsells, M.C., Corcoy, R.M., Lleonart, R.B., Pujol, R.V., Mauricio, D.P., García, A.P., Pou, J.M. and Cisteró, A.B. (1991) Primary Allergy to Human Insulin in Patient with Gestational Diabetes. Diabetes Care, 14, 423-424.
 Takuma, H., Kawagishi, T., Kyogoku, I., Okuno, Y., Nishizawa, Y. and Morii, H. (1995) A Case of Primary and Generalized Allergy to Human Insulin with No History of Any Prior Insulin Exposure. Diabetes Research and Clinical Practice, 30, 69-73. http://dx.doi.org/10.1016/0168-8227(95)01147-1
 Matsumura, M., Kawai, K., Watanabe, Y., Tomizawa, H., Nakamura, S., Murayama, Y., Kuzuya, N., Itakura, M., Fujita, T. and Yamashita, K. (1990) A Case of Insulin Allergy Associated with Marked Eosinophilia, High Titer of Insulin Antibodies and Enlargement of Surperficial Lymph Nodes. Journal of the Japan Diabetes Society, 33, 231-235. (in Japanese)
 Yoshino, K., Takeda, N., Matsumura, M., Morita, H., Sou, T., Ishizuka, T. and Yasuda, K. (1999) A Case of Diabetes with Systemic Allergy to Human Insulin and Protamine. Journal of the Japan Diabetes Society, 42, 927-930. (in Japanese)
 Imakado, S., Hamada, K. and Atsumi, Y. (2009) Subcutaneous Antihistamine Injection Is Effective to Control a Local Allergic Reaction to Human Insulin. Diabetes Research and Clinical Practice, 85, e42-e43. http://dx.doi.org/10.1016/j.diabres.2009.05.013
 Nagai, T., Nagai, Y., Tomizawa, T. and Mori, M. (1997) Immediate-Type Human Insulin Allergy Successfully Treated by Continuous Subcutaneous Insulin Infusion. Internal Medicine, 36, 575-578. http://dx.doi.org/10.2169/internalmedicine.36.575
 Kumar, D. (1997) Lispro Analog for the Treatment of Generalized Allergy to Human Insulin. Diabetes Care, 20, 1337-1359. http://dx.doi.org/10.2337/diacare.20.9.1357