Solitary pancreas transplantation for life-threatening allergy to human insulin
(2006) Transplant International — Vol. 19, n° 6, p. 474-477 (2006)
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- Abstract
- We report on a 30-year-old man, with type 1 diabetes mellitus, who developed generalized allergy to insulin consisting of several bouts of tremor, tachycardia, breathlessness and syncope. Strong positive reactions to protamine and metacresol were demonstrated by skin-prick testing. Symptoms persisted despite the use of antihistamine therapy, Actrapid HM Paraben and Monotard (insulin without protamine and metacresol) and immunosuppression (tacrolimus). He underwent a cadaver pancreas transplantation with portal-enteric drainage in June 2003. Following the antithymocyte globulin induction, immunosuppression consisted in tacrolimus and sirolimus without steroids. The patient subsequently reported a complete resolution of his symptoms and excellent glycaemic control. Thirteen months after transplantation, the patient developed oral ulcerations and severe leucopoenia initially attributed to sirolimus, which was subsequently stopped. A hyperglycaemic episode following corticosteroid therapy for acute rejection therapy required the reintroduction of insulin. Allergic manifestations reappeared promptly. Currently, 2 years after transplantation, the patient is euglycaemic without insulin (glycated haemoglobin 5.8%) and he is free of allergic reactions.
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Citations
Leonet, J., Malaise, J., Goffin, E., Lefebvre, C., Tennstedt, D., Vandeleene, B., Buysschaert, M., & Squifflet, J.-P. (2006). Solitary pancreas transplantation for life-threatening allergy to human insulin. Transplant International, 19(6), 474-477. https://doi.org/10.1111/j.1432-2277.2006.00282.x (Original work published 2006)