Solitary pancreas transplantation for life-threatening allergy to human insulin
| Autor: | Chantal Lefebvre, Martin Buysschaert, Jean-Paul Squifflet, Bernard Vandeleene, Dominique Tennstedt, Jacques Malaise, Eric Goffin, Jacqueline Léonet |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Hypersensitivity Immediate Male medicine.medical_specialty medicine.medical_treatment Pancreas transplantation Gastroenterology Tacrolimus Insulin resistance Internal medicine Diabetes mellitus medicine Hypersensitivity Homeostasis Humans Insulin Protamines Sirolimus Type 1 diabetes Transplantation business.industry Immunosuppression medicine.disease Surgery surgical procedures operative Diabetes Mellitus Type 1 Pancreas Transplantation Insulin Resistance business Immunosuppressive Agents |
| Zdroj: | Transplant international : official journal of the European Society for Organ Transplantation. 19(6) |
| ISSN: | 0934-0874 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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