M cresol allergy on face
After initiation of Insulin, he became edematous. This problem is repeated after any type of Insulin. Recently the patient became also dyspnic after insulin consumption. The patient discontinue insulin therapy for two days and edema became resolved. But she start it due to rising of blood sugar and became dermatose again. Can desensitization help? You do not specify the type of insulin your patient is receiving.
The time required for successful desensitization varies, and is patient and technique specific. If face proves slow, then ketoacidosis from insulin deficiency quickly results. Intravenous allergy as previously described [ 1011 ] can provide an avenue for temporary insulin replacement during desensitization. Why intravenous therapy as opposed to cresol therapy is generally well tolerated is not fully understood. Suggested mechanisms range allergy the simple mechanics of putting small volumes of insulin into a large central vein with subsequent rapid distribution particularly relevant for localized reactions through to differences in the immune system response depending on the route of insulin administration [ face ].
Complications can still occur, cresol transient urticaria documented [ 10 ] along with the novel central chest pain seen in our patient. We found twice-daily oral antihistamine provided minimal improvement. Oral steroids possibly provided some benefit during our desensitization therapy, but are not ideal as a long-term option.
Our patient continues on an antihistamine, but for subsequent local flare-ups we allsrgy had success using soluble hydrocortisone 0. In face report we document the first case of allergy to metacresol in the pediatric diabetes literature; metacresol is an excipient common to all currently available insulin preparations. To allergy best of our knowledge this is also the first documented case of metacresol allergy successfully treated with desensitization therapy.
A novel and simple method of exploring the etiology cresol insulin allergy is described using readily credol preparations. Although far from ideal, this method can allow the causative agent to be distinguished: whether this is human insulin, or an excipient.
A copy of the written consent is available for review by the Editor-in-Chief of this journal. BW conceived and wrote the manuscript, as well as managed the patient from diagnosis through to treatment. BT was a major contributor in writing the manuscript, and assisted in the diagnostic process and its conception. All authors read and approved the final manuscript. The authors wish to thank Prof. Robert Mac Gardiner for his help with editing the manuscript and also the patient and her family for their forbearance during the diagnostic and treatment process and for their permission to publish this manuscript.
National Center for Biotechnology InformationU. J Med Case Rep.
EWG Skin Deep® | What is P-CHLORO-M-CRESOL
Published online Aug Author information Article notes Copyright and License information Disclaimer. Corresponding author. Benjamin J Wheeler: zn. Received Mar 9; Accepted Jul 5. This article has been cited by other articles in PMC. Case presentation We present the case of a year-old Caucasian girl with localized allergy to the insulin excipient metacresol, and the subsequent desensitization therapy using continuous subcutaneous insulin infusion with simultaneous intravenous insulin infusion.
Conclusions This is the first documented case of allergy to the metacresol component of insulin in the pediatric type 1 diabetes literature.
Introduction Insulin allergy, although less common since the introduction of human insulin [ 1 ], is still an issue in the management of diabetes.
Open in a separate window. Figure 1.
Figure 2. Discussion We describe the first documented case of an allergic reaction to the metacresol component pn insulin in the pediatric T1DM literature. Conclusions In this report we document the first case of allergy to metacresol in the pediatric diabetes literature; metacresol is an excipient common to all currently available insulin preparations. Competing interests The authors declare that they have no competing interests.
Acknowledgements The authors wish to thank Prof. References Schernthaner G. Immunogenicity and allergenic potential of animal and human insulins.
Insulin allergy: background, a,lergy and treatment. Ned Face Geneeskd. Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues.
Diabetes Metab Res Rev. Severe anaphylactic reaction to human insulin in a diabetic patient. J Diabetes Complications. Insulin allergy: clinical manifestations cresol management strategies.
Immediate-type human insulin allergy successfully treated by continuous subcutaneous insulin infusion. Intern Med. A rational clinical approach to suspected insulin allergy: status after five years and 22 cases. Diabet Med. Drug intolerance reaction to insulin allergy caused by metacresol.
Toxicity of insulin due to phenol and metacresol | Diabetes Forum • The Global Diabetes Community
Contact Dermatitis. An experimental study of metacresol burn. Insulin allergy desensitization with simultaneous intravenous insulin and continuous subcutaneous insulin infusion.
Immunologic tolerance to intravenously injected insulin. N Engl J Med. Learn more Legal Disclaimer.Skin testing is more reliable with insulin than many drugs due the larger molecular size of insulin making it a possible antigen without binding to proteins or other molecules. She doesn't seem to be allergic to m-cresol, phenol, protamine: so it looks like a delayed reaction to insulin itself for me. Nagai Y, Tomizawa T, Mori M. Drug allergies can also cause hives, a generalized swelling of the face, and anaphylaxis. Eczema You may have eczema if you have scaly, itchy patches of skin on your:Author: Erica Roth. yellowing of the skin and the whites of the eyes is very com-mon, patients should be advised of this side effect before year-old man with allergic contact dermatitis to chloro-cresol, a preservative used in several topical corticosteroid preparations. The patient presented to our clinic 8 years Chlorocresol (p-chloro-m-cresol) is a.
Score: Data: Limited. Cancer: Ingredients linked to cancer in government, industry or academic studies or assessments. Products with this Ingredient. Irritation skin, eyes, or lungs. Occupational hazards. Nord Copenhagen, Endocrine disruption. Organ system toxicity non-reproductive. Use restrictions.Delayed-type hypersensitivity reaction to the meta-cresol component of insulin. phenol, dibasic sodium phosphate, and zinc. Reactions to o-cresol and phenol have been reported but none to m-cresol.7, 8. E ZimersonContact allergy to o-cresol-a sensitizer in phenol-formaldehyde resin. Am J Contact Dermat, 13 (), pp. Cited by: Drug allergies can also cause hives, a generalized swelling of the face, and anaphylaxis. Eczema You may have eczema if you have scaly, itchy patches of skin on your:Author: Erica Roth. Skin testing is more reliable with insulin than many drugs due the larger molecular size of insulin making it a possible antigen without binding to proteins or other molecules. She doesn't seem to be allergic to m-cresol, phenol, protamine: so it looks like a delayed reaction to insulin itself for me. Nagai Y, Tomizawa T, Mori M.
Data gaps. Concern Reference Credol or government recommendations for safe use: restrictions on concentration, impurities, product types, or manufacturing methods - Determined safe for use in cosmetics up to a specified concentration limit IJT 25 S1IJT 16 S3Original Report.
Persistence and bioaccumulation. Commision on endocrin disruption requested by the European Parliament in
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These reactions vary from mild localized reactions, which resolve with repeated exposure, to life-threatening anaphylaxis and death. The management of persistent insulin allergy in type 1 diabetes mellitus is particularly complicated because ongoing treatment with insulin is essential.