Localized insulin amyloidosis with use of concentrated insulin: a potential complication

• DOI: 10.1111/dme.13137
• Publication Date: 2016-04-18T05:46:36Z
• Authors: A. Mangla; G. J. Kim; N. Agarwal; S. Khurana; R. Catchatourian; J. J. Jiang
• Keywords: NPH insulin; Amyloid (mycology)

Insulin-derived amyloidosis is a rare form of composed insulin fibrils. The pH and concentration are known to influence the conformational state hormone, with an increasing favouring more complex conformation. Concentrated delivers large amount localized area, raising possibility inducing changes, forming fibrils leading amyloidosis.A middle-aged woman long history Type 2 diabetes mellitus, treated concentrated human (U-500 insulin) presented nodular lesions at site her daily injections. A punch biopsy nodules showed skin dermal staining favourably Congo Red stain. amyloid tumours were resected areas positive for stain sent liquid chromatography tandem mass spectrometry, which peptide profile consistent insulin.Concentrated was first introduced in 1952, however, it only over last two decades that has been used increasingly, congruence incidence obesity mellitus seen USA. Only few cases injection have described literature. With increase use insulin, this complication seems be occurring frequently. This case report person who developed points towards potential developing insulin.