多种人胰岛素致过敏反应

Allergic reaction caused by a variety of human insulin

1例69岁女性糖尿病患者,入院前4个月使用人胰岛素类似物,用药2 d后注射部位皮下结节,伴刺痛。入院前1个月改为精蛋白锌重组人胰岛素混合注射液,注射2 d出现皮下结节,伴刺痛。入院后实验室检查:嗜酸粒细胞计数为0.44×109.L-1,嗜酸粒细胞百分比为7.3%,胰岛素自身抗体阳性。根据皮肤试验,选用人低精蛋白胰岛素,同时口服格列吡嗪片、马来酸罗格列酮片及盐酸二甲双胍片。患者血糖控制良好,注射部位无硬结。

One 69-year-old woman with diabetes mellitus received insulin analogue about 4 months before hospitalization, and 2 days later, the patient developed subcutaneous nodules at injection site with tingling. One month before hospitalization, the regimen was substituted for human insulin, and 2 days later, there still were subcutaneous nodules at injection site with tingling. After admission, laboratory tests revealed eosinophils count of 0.44 x 10^9L-1, the rate of eosinophils was 7.3% and IAA examination was positive. The skin testing was performed in order to select an appropriate insulin preparation. Human isophane insulin was selected based on the skin testing and glipizide tablets, rosiglitazone tablets and metformin tablets were given orally. The patient had a well control of blood glucose and subcutaneous nodules did not recur.