tailieunhanh - Báo cáo y học: "Successful desensitization with human insulin in a patient with an insulin allergy and hypersensitivity to protamine: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful desensitization with human insulin in a patient with an insulin allergy and hypersensitivity to protamine: a case report | Journal of Medical Case Reports BioMed Central Open Access Case report Successful desensitization with human insulin in a patient with an insulin allergy and hypersensitivity to protamine a case report Claudia Pfohler Cornelia SL Muller Dirk O Hasselmann and Wolfgang Tilgen Address The Saarland University Hospital Department of Dermatology 66421 Homburg Saar Germany Email Claudia Pfohler - hacpfo@ CorneliaSLMuller-c_mueller1977@ Dirk O Hasselmann - fetzinger@ Wolfgang Tilgen - hawtil@ Corresponding author Published 26 August 2008 Received 9 January 2008 Journal of Medical Case Reports 2008 2 283 doi 1752-1947-2-283 Accepted 26 August 2008 This article is available from http content 2 1 283 2008 Pfohler et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract_ Introduction Insulin allergy may occur in patients treated with subcutaneous applications of insulin preparations. Besides additives in the insulin preparation such as protamine cresol and phenol the insulin molecule itself may be the cause of the allergy. In the latter case therapeutic options are rare. Case presentation A 68-year-old man with poorly controlled type 2 diabetes mellitus received different insulin preparations subcutaneously while on oral medication. Six to eight hours after each subcutaneous application he developed pruritic plaques with a diameter of 15 cm at the injection sites that persisted for several days. Allergologic testing revealed positive reactions against every insulin preparation and against protamine. Investigation of serum samples demonstrated IgG antibodies against human and