Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature

Figure 1

Types of hypersensitivity associated with insulin-related allergy reactions. Type I hypersensitivity reaction is characterized to be a TH2-controlled IgE-insulin specific mediated process, with local edema, itching, wheals, and flares, which could also be associated with angioedema. Type III hypersensitivity is mediated by antigen-antibody complex and recruitment of complement C1q, with subsequent edema, necrosis, and nodule formation. Finally, Type IV reactions are CD8-cytotoxic specific with subcutaneous edema, itching, and hyperkeratosis.