摘要
1例56岁女性糖尿病患者,入院前约3年使用人正规胰岛素,用药15min后注射部位皮下结节,伴瘙痒,1～4d可自行消失,并有夜间阵发性干咳。入院前6个月后改为人低精蛋白锌胰岛素,夜间干咳消失,但皮下结节存在。入院后实验室检查:嗜酸粒细胞计数0.62×109/L,嗜酸粒细胞百分比为0.69,血糖8.4mmol/L,免疫球蛋白E96.60U/mL,胰岛素自身抗体(IAA)阳性。入院当日出现哮喘发作,经治疗症状缓解。为选择适宜胰岛素制剂行皮肤试验,根据皮肤试验,选用人低精蛋白锌胰岛素10U/次,同时口服阿卡波糖、二甲双胍及吡格列酮。患者血糖控制良好,注射局部间断出现可消退的小硬结、偶有瘙痒,夜间干咳消失,无哮喘发作。
A 56-year-old woman with diabetes mellitus received human regular insulin about 3 years before hospitalization,and 15 minutes affter injection,the patient developed subcutaneous nodules at injection site with pruritus,which subside spontaneously in 1-4 days,and paroxysaml nocturnal dry cough. Six months before hospitalization,the regimen was instead of human isophane insulin and subcutaneous nodules remained,but dry cough at night disappeared. After admission,laboratory tests revealed eosinophils count of 0.62×10^9/L and the rate of eosinophils was 0.69. A IgE level was 96.60 U/mL and IAA examination was positive. On admission,she presented with asthma and the symptoms improved after treatments. The skin testing was performed in order to select an appropriate insulin preparation. Human isophane insulin 10 U once was selected based on the skin testing and acarbose,metformin,and pioglitazone were given. The patient had a well control of blood glucose and developed intermittent small scleroma which was subsided spontaneously,occasional pruritus,and dry cough and asthma did not recur.
出处
《药物不良反应杂志》
2010年第4期289-290,共2页
Adverse Drug Reactions Journal
