Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Allergy, Dermatology, acrylates, allergic contact dermatitis, delayed hypersensitivity, glucose sensor, insulin pump, isobornyl acrylate, medical device, Acrylates, Adhesives, Adolescent, Adult, Blood Glucose Self-Monitoring, Camphanes, Child, Preschool, Dermatitis, Allergic Contact, Female, Home Infusion Therapy, Humans, Infusion Pumps, Male, Middle Aged, Patch Tests, Resins, Plant, 1103 Clinical Sciences, 1107 Immunology, Dermatology & Venereal Diseases, 3202 Clinical sciences, 3204 Immunology

Abstract:

BACKGROUND: The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens. OBJECTIVES: To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set. PATIENTS AND METHODS: Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed. RESULTS: Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set. CONCLUSIONS: IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.