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Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre
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- Herman, Anne (author)
- Saint-Luc University Hospital
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- Mowitz, Martin (author)
- Lund University,Lunds universitet,Yrkes- och miljödermatologi,Forskargrupper vid Lunds universitet,Occupational and Environmental Dermatology,Lund University Research Groups,Skåne University Hospital
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- Aerts, Olivier (author)
- Antwerp University Hospital
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- (creator_code:org_t)
- 2019-07-21
- 2019
- English.
- In: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 81:5, s. 354-367
- Journal article (peer-reviewed)
Abstract
Subject headings
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- Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA. Conclusion: Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist. Highlights: Of the diabetic patients sensitized to the glucose sensor FreeStyle Libre and/or IBOA, 62.3% reacted positively to SLM. Cross-reactions between IBOA and the three components of SLM (alantolactone, costunolide, and dehydrocostus lactone) seem unlikely, because of their different spatial structures. Co-sensitization between IBOA and SLS can be explained by the fact that there is a common precursor, such as camphene, between these two molecules.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
Keyword
- allergic contact dermatitis
- chemical analysis
- diabetes mellitus
- FreeStyle Libre
- GC-MS
- glucose sensor
- isobornyl acrylate
- medical device
- sesquiterpene lactones
- simultaneous reactions
Publication and Content Type
- art (subject category)
- ref (subject category)
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- Herman, Anne
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- Aerts, Olivier
- Pyl, Jeroen
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- Bruze, Magnus
- Baeck, Marie
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