Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature
Joint Authors
Martínez, María Sofía
Mejías, José
Torres, Wheeler
Miquilena, Edgar
Bermúdez, Valmore
Chávez, Mervin
Rojas, Joselyn
Villalobos, Marjorie
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-11-19
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Introduction.
Insulin allergy is a rare complication of insulin therapy, especially in type 1 diabetes mellitus (T1DM).
Key manifestations are hypersensitivity-related symptoms and poor metabolic control.
T1DM, as well as insulin allergy, may develop in the context of autoimmune polyendocrine syndrome (APS), further complicating management.
Case Report.
A 17-year-old male patient, diagnosed with T1DM, was treated with various insulin therapy schemes over several months, which resulted in recurrent anaphylactoid reactions and poor glycemic control, after which he was referred to our Endocrinology and Immunology Department.
A prick test was carried out for all commercially available insulin presentations and another insulin scheme was designed but proved unsuccessful.
A desensitization protocol was started with Glargine alongside administration of Prednisone, which successfully induced tolerance.
Observation of skin lesions typical of vitiligo prompted laboratory workup for other autoimmune disorders, which returned positive for autoimmune gastritis/pernicious anemia.
These findings are compatible with APS type 4.
Discussion.
To our knowledge, this is the first documented case of insulin allergy in type 4 APS, as well as this particular combination in APS.
Etiopathogenic components shared by insulin allergy and APS beg for further research in immunogenetics to further comprehend pathophysiologic aspects of these diseases.
American Psychological Association (APA)
Rojas, Joselyn& Villalobos, Marjorie& Martínez, María Sofía& Chávez, Mervin& Torres, Wheeler& Mejías, José…[et al.]. 2014. Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature. Case Reports in Immunology،Vol. 2014, no. 2014, pp.1-9.
https://search.emarefa.net/detail/BIM-1034756
Modern Language Association (MLA)
Rojas, Joselyn…[et al.]. Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature. Case Reports in Immunology No. 2014 (2014), pp.1-9.
https://search.emarefa.net/detail/BIM-1034756
American Medical Association (AMA)
Rojas, Joselyn& Villalobos, Marjorie& Martínez, María Sofía& Chávez, Mervin& Torres, Wheeler& Mejías, José…[et al.]. Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature. Case Reports in Immunology. 2014. Vol. 2014, no. 2014, pp.1-9.
https://search.emarefa.net/detail/BIM-1034756
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1034756