인슐린 알레르기 환자에서 탈감작 후 나타난 인슐린 특이항체의 변화 1예

• Published in: Chʻŏnsik mit alrerugi pp. 63 - 67
• Main Authors: 김민혜, 임경환, 박한기, 김병근, 강민구, 권재우, 김태완, 정재우, 이소희, 이상민, 박흥우, 강혜련, 장윤석, 김선신, 조상헌, 민경업, 김유영, 김세훈
• Format: Journal Article
• Language: Korean
• Published: 대한천식알레르기학회 01.03.2010
• Subjects: 임상병리학
• ISSN: 1226-8739

Although human insulin is widely used, insulin allergy is still an important issue. Desensitization is one of the strategies to overcome insulin allergy, but there are few report concerning the mechanism of immune tolerance to insulin achieved by desensitization. Based on the previous studies regarding immunotherapy, it can be understood that changes in allergen specific antibody may be a probable mechanism. We report time-serial changes in insulin- specific antibodies after successful desensitization of type I hypersensitivity to insulin. A 68-year-old man visited our clinic due to dyspnea, loss of consciousness and whole body rash with erythema immediately after the injection of human insulin. The patients showed positive skin reactions to all available human insulins. Enzyme linked immunosorbent assay (ELISA) demonstrated that human insulin specific IgE level increased. We injected human insulin (aspart) to patient subcutaneously with gradual increase manners and finally achieved successful insulin desensitization without serious systemic reactions. Human insulin-specific antibody was measured 4, 8 and 12 weeks after desensitization, which showed interesting time-serial changes; specific IgE gradually decreased, while IgG1, IgG2 and IgG4 gradually increased. KCI Citation Count: 1