A case of insulin allergy: the crystalline human insulin may mask its antigenicity.

Abstract

We report an unusual case of insulin allergy. A 48-year-old man with non-insulin-dependent diabetes mellitus receiving biosynthetic isophane human insulin (Humulin N) developed itchy wheal-and-flare reactions at the sites of injection. When Humulin N was changed to a semi-synthetic crystalline human insulin zinc (Novolin U), the allergic reactions completely disappeared. Evaluation of his serum showed a high level of insulin-specific IgE. Skin testing with all commercially available insulins showed immediate local reactions to all agents tested except for Novolin U. In addition, decrystallized Novolin U prepared by lowering the pH with acetic acid also induced a positive reaction. These observations suggest that the crystallized structure of human insulin may mask its antigenicity for allergic reactions.

• Authors: H Takatsuki, H Ishii, T Yamauchi, N Nakashima, S Nagase, A Hisatomi, F Umeda, H Nawata
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 12 Issue 2 Pg. 137-9 (May 1991) ISSN: 0168-8227 [Print] Ireland
• PMID: 1879305 (Publication Type: Case Reports, Journal Article)

Chemical References

• Insulin
• Immunoglobulin E

Topics

• Diabetes Mellitus, Type 2 (drug therapy)
• Drug Hypersensitivity
• Humans
• Immunoglobulin E (analysis)
• Insulin (adverse effects, therapeutic use)
• Male
• Middle Aged
• Skin Tests