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Allergic Response to Glucagon Injection as a Result of Insulin Contamination

The Divisions of Endocrinology and Metabolism, and Allergy and Immunology, Department of Medicine and Clinical Research Center, University of Tennessee Center for the Health Sciences Memphis, Tennessee 38163

Reprints: Dr. Abbas E. Kitabchi, Department of Medicine, University of Tennessee Center for the Health Sciences, 951 Court Avenue, Memphis, Tennessee 38163.

A 25-year-old obese woman with adult onset diabetes, with known insulin allergy, was evaluated for her insulin response to glucagon. Intravenous injection of glucagon produced severe generalized allergic reaction. Skin tests with various insulin and glucagon preparations showed allergic reaction to be most pronounced with beef regular single peak and single component insulin, pork regular single peak, beef lente single peak, and neutral regular (beef-pork) single peak insulin. Allergic reactions to numerous glucagon preparations were found to be directly proportional to the amount of insulin contamination in those preparations. Purification of one glucagon lot by column chromatography verified the presence of proinsulin and insulin contaminants in the preparation.

Supported in part by training grant AM 05497, USPHS grant AM 15509, and Clinical Research Center grant RR 00211.

Received May 19, 1975.

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