RESUMO
A 34-year-old woman developed gestational diabetes and was treated with insulin (beef-pork and beef) and oral therapy at various periods. She developed an insulin allergy; however, attempts at desensitization with the commercially available purified pork insulin desensitization kit (Eli Lilly Co.) were not successful. Reactivity to human (recombinant DNA) insulin as well as elevated IgE levels and eosinophilia were also demonstrated. A second desensitization attempt with human (recombinant DNA) insulin using a protocol developed by the authors was successful. This report discusses a desensitization procedure using human insulin in an insulin-allergic patient.
Assuntos
Hipersensibilidade a Drogas/terapia , Insulina/uso terapêutico , Gravidez em Diabéticas/tratamento farmacológico , Proteínas Recombinantes/uso terapêutico , Adulto , Animais , Bovinos , Dessensibilização Imunológica , Feminino , Humanos , Insulina/efeitos adversos , Gravidez , SuínosRESUMO
One hundred fifty-three pregnant patients were included in this study to verify the amount of drugs ingested during their pregnancies. The results demonstrate that, unknown to the physician, pregnant patients take a variety of pharmacologic agents. The patient's medical record is considered grossly inadequate in documenting an accurate assessment of a patient's exposure to drugs taken during pregnancy. Drug histories were obtained utilizing the hospital pharmacist drug history interview and home diary. Validity testing of the pharmacist's drug history and of the medical record history was not performed. The patient's compliance for utilizing the home diary for drugs or chemicals taken during their pregnancy was 83% (127 patients). It was shown that the usual methods of drug history documentation will identify only 30% of the actual drug exposure to the fetus.
