Pancreas transplantation for treatment of generalized allergy to human insulin in type 1 diabetes
(2005) Transplantation Proceedings — Vol. 37, n° 6, p. 2839 (2005)
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- Abstract
- We report the case of a 29-year-old man with a 14-year history of type 1 diabetes, normal renal function, and mild diabetic retinopathy. The patient progressively developed a generalized allergic reaction to two insulin excipients--protamine and metacresol--with systemic manifestations of tremor, tachycardia, vertigo, shortness of breath, and short episodes of unconsciousness causing him to be out of work. In June 2003, he received a vascularized cadaveric pancreas transplant using induction with polyclonal antibodies along with tacrolimus and sirolimus but without steroids. A hyperglycemic episode following corticosteroid therapy for rejection treatment required reintroduction of insulin therapy with prompt reappearance of allergic manifestations. Now, the patient is euglycemic without insulin or allergic manifestations and a glycated hemoglobin of 6.4%.
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Citations
Malaise, J., Vandeleene, B., Léonet, J., Goffin, E., Lefebvre, C., Tennstedt, D., Buysschaert, M., & Squifflet, J.-P. (2005). Pancreas transplantation for treatment of generalized allergy to human insulin in type 1 diabetes. Transplantation Proceedings, 37(6), 2839. https://doi.org/10.1016/j.transproceed.2005.05.020 (Original work published 2005)