Highlights the risk of anaphylaxis during desensitization with single-component pork insulin in patients with severe local reactions.
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Anaphylaxis risk warrants caution during pork insulin desensitization; leaves open safer protocols for severe insulin allergy.
A PATIENT who initially exhibited local skin erythema to single-component pork insulin went into anaphylaxis during single-component pork insulin desensitization. Case Report A 47-year-old woman with a five-month history of severe local erythema surrounding sites of insulin injection was admitted to Hahnemann Hospital for insulin desensitization. She did well in the hospital and for about two weeks after discharge with beef-pork isophane insulin suspension, but then, severe erythema and induration developed at the sites of insulin administration. A change to pork insulin zinc suspension (Lente) was no better. Skin tests employing beef- and pork-regular insulins, as well as pork insulin zinc suspension showed positive skin responses at the lowest insulin dilutions (0.001 units). Desensitization was attempted with single-component regular pork insulin according to the protocol shown in the Table. The patient had been supported with 10 units of pork insulin at six hourly intervals for 24 hours prior to the
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Robert A. Goldman (1976) studied this question.
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