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Insulin‐derived amyloidosis without a palpable mass at the insulin injection site: A report of two cases
Authors:Terumasa Nagase  Keiichi Iwaya  Koichiro Kogure  Tamotsu Zako  Yohei Misumi  Minoru Kikuchi  Koichi Matsumoto  Masayuki Noritake  Yasuhiro Kawachi  Masaki Kobayashi  Yukio Ando  Yoshiya Katsura
Abstract:To date, almost all case reports of insulin‐derived amyloidosis described the presence of a subcutaneous mass that was observable on physical examination. This report presents two cases of insulin‐derived amyloidosis without palpable masses at insulin injection sites. In both cases, blood glucose concentrations improved, and the insulin dose could be reduced by an average of 45% after changing the insulin injection sites. The insulin absorption at the site was reduced to at most 40% of that at a normal site in one case. Magnetic resonance imaging and ultrasonography were useful to screen and differentiate insulin‐derived amyloidosis without a palpable mass. This report showed that insulin‐derived amyloidosis without a palpable mass can be present at the insulin injection site, and has similar clinical effects to insulin‐derived amyloidosis with palpable masses.
Keywords:Amyloid  Insulin  Subcutaneous injections
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