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- Title
Anaphylaxis and immunologic insulin resistance in a diabetic woman with ketoacidosis.
- Authors
Ross, Jonathan M.; Murali, Mandakolathur R.; DeLara, Teresita C.; Cheron, Robert G.; Ross, J M; Murali, M R; DeLara, T C; Cheron, R G
- 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.
- Subjects
IMMUNOGLOBULIN analysis; ANAPHYLAXIS; DIABETIC acidosis; DRUG allergy; INSULIN; INSULIN resistance; SKIN tests; DISEASE complications
- Publication
Diabetes Care, 1984, Vol 7, Issue 3, p276
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/diacare.7.3.276