Anaphylaxis and Red Cell Survival Studies in a Child With Insulin‐resistant Diabetes Mellitus

Abstract

Summary A child with the syndrome of diabetes mellitus, insulin‐resistance, Coombs' positive autoimmune hemolytic anemia, lymphadenopathy, and hepatosplenomegaly was described. The patient's IgG anti‐insulin antibody was shown to be negative for passive cutaneous anaphylaxis (PCA). In as much as the patient was refractory to prednisone therapy and presented a negative PCA test, he was consistent with the Oakley hypothesis that insulin‐resistant prednisone‐insensitive patients will be negative for PCA. The half‐life of the patient's red blood cells was shown to vary as a function of the type of insulin used in therapy. The child was shown to have immune‐complexes in his serum of insulin‐anti‐insulin specificity, and it was suggested that these complexes are partially responsible for the microangiopathy that is so often observed in diabetes mellitus.