PMID- 563170
OWN - NLM
STAT- MEDLINE
DCOM- 19780127
LR  - 20190626
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 63
IP  - 5
DP  - 1977 Nov
TI  - Insulin antibodies in the pathogenesis of insulin allergy and resistance.
PG  - 703-9
AB  - Insulin allergy developed in a patient treated with beef/pork insulin. 
      Desensitization therapy led to cessation of the allergy, but it was associated 
      with the development of diabetic ketoacidosis with apparent insulin resistance 
      which was successfully treated with fish insulin. The patient's initial serum 
      contained a high titer of anti-insulin immunoglobulin E (IgE) antibody directed 
      primarily against beef insulin. Desensitization therapy with pork insulin was 
      associated with the production of anti-insulin immunoglobulin G (IgG) antibody 
      with highest immunologic reactivity to pork insulin. This IgG antibody may have 
      blocked the interaction of insulin with tissue-fixed IgE antibody but, in 
      addition, led to significant increases in total serum insulin-binding capacity 
      and transient insulin resistance. The favorable clinical response to fish insulin 
      was likely due to the negligible immunologic reactivity of this patient's 
      anti-insulin antibodies with fish insulin. This report suggests that 
      desensitization therapy for insulin allergy can lead to insulin resistance of the 
      immune type.
FAU - Witters, L A
AU  - Witters LA
FAU - Ohman, J L
AU  - Ohman JL
FAU - Weir, G C
AU  - Weir GC
FAU - Raymond, L W
AU  - Raymond LW
FAU - Lowell, F C
AU  - Lowell FC
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Insulin)
RN  - 0 (Insulin Antibodies)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Animals
MH  - Cattle
MH  - Desensitization, Immunologic
MH  - Drug Hypersensitivity/drug therapy/*immunology
MH  - Female
MH  - Fishes
MH  - Humans
MH  - Immunoglobulin E
MH  - Insulin/*adverse effects/therapeutic use
MH  - *Insulin Antibodies/analysis
MH  - *Insulin Resistance
MH  - Middle Aged
MH  - Swine
EDAT- 1977/11/01 00:00
MHDA- 1977/11/01 00:01
CRDT- 1977/11/01 00:00
PHST- 1977/11/01 00:00 [pubmed]
PHST- 1977/11/01 00:01 [medline]
PHST- 1977/11/01 00:00 [entrez]
AID - 0002-9343(77)90155-3 [pii]
AID - 10.1016/0002-9343(77)90155-3 [doi]
PST - ppublish
SO  - Am J Med. 1977 Nov;63(5):703-9. doi: 10.1016/0002-9343(77)90155-3.