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- W2022910414 abstract "RationaleAllergic reactions to systemic corticoids are uncommon, especially immediate-type reactions. Here we present a patient with an anaphylactic reaction due to 6-methyl-prednisolone.MethodsAfter written informed consent, we perfomed the following drug allergy studyResultsA 38 year-old man received a single intravenous dose of 6-methyl-prednisolone (40 mg) to treat an asthma attack. Immediately after the dose he suffered abdominal pain, nausea, vomiting and generalized pruritus, angioedema in his lips, hands and face. After this, dizziness, tachycardia, and intense sweating appeared. He was treated with intramuscular epinephrine, intravenous saline fluid and an intravenous dose of difenhidramine (polaramine ®). He was under hospital observation until he completely recovered.We performed a prick test with soluble 6 methyl-prednisolone (hemisuccinate ester) with a positive result (7 mm diameter). The prick and intradermal tests with oral methyl-prednisolone (succinate ester), hidrocortisone, prednisone and fluticasone were negative.We perfomed an oral challenge test with oral prednisone up to 80 mg, intravenous hydrocortisone up to 200 mg and 1 puff of inhaled fluticasone (250 mcg), all of them with good tolerance.ConclusionsWe have diagnosed an anaphylactic reaction caused by 6-methyl-prednisolone confirmed by a positive prick test. We have confirmed that the patient tolerated methyl-prednisolone, and so we think that he was sensitized only to hemisuccinate but not to succinate esters as in other published cases. Due to the widespread use of these drugs, it’s important to give safe corticoids alternatives to these patients performing drug challenges after negative prick or intradermal tests. RationaleAllergic reactions to systemic corticoids are uncommon, especially immediate-type reactions. Here we present a patient with an anaphylactic reaction due to 6-methyl-prednisolone. Allergic reactions to systemic corticoids are uncommon, especially immediate-type reactions. Here we present a patient with an anaphylactic reaction due to 6-methyl-prednisolone. MethodsAfter written informed consent, we perfomed the following drug allergy study After written informed consent, we perfomed the following drug allergy study ResultsA 38 year-old man received a single intravenous dose of 6-methyl-prednisolone (40 mg) to treat an asthma attack. Immediately after the dose he suffered abdominal pain, nausea, vomiting and generalized pruritus, angioedema in his lips, hands and face. After this, dizziness, tachycardia, and intense sweating appeared. He was treated with intramuscular epinephrine, intravenous saline fluid and an intravenous dose of difenhidramine (polaramine ®). He was under hospital observation until he completely recovered.We performed a prick test with soluble 6 methyl-prednisolone (hemisuccinate ester) with a positive result (7 mm diameter). The prick and intradermal tests with oral methyl-prednisolone (succinate ester), hidrocortisone, prednisone and fluticasone were negative.We perfomed an oral challenge test with oral prednisone up to 80 mg, intravenous hydrocortisone up to 200 mg and 1 puff of inhaled fluticasone (250 mcg), all of them with good tolerance. A 38 year-old man received a single intravenous dose of 6-methyl-prednisolone (40 mg) to treat an asthma attack. Immediately after the dose he suffered abdominal pain, nausea, vomiting and generalized pruritus, angioedema in his lips, hands and face. After this, dizziness, tachycardia, and intense sweating appeared. He was treated with intramuscular epinephrine, intravenous saline fluid and an intravenous dose of difenhidramine (polaramine ®). He was under hospital observation until he completely recovered. We performed a prick test with soluble 6 methyl-prednisolone (hemisuccinate ester) with a positive result (7 mm diameter). The prick and intradermal tests with oral methyl-prednisolone (succinate ester), hidrocortisone, prednisone and fluticasone were negative. We perfomed an oral challenge test with oral prednisone up to 80 mg, intravenous hydrocortisone up to 200 mg and 1 puff of inhaled fluticasone (250 mcg), all of them with good tolerance. ConclusionsWe have diagnosed an anaphylactic reaction caused by 6-methyl-prednisolone confirmed by a positive prick test. We have confirmed that the patient tolerated methyl-prednisolone, and so we think that he was sensitized only to hemisuccinate but not to succinate esters as in other published cases. Due to the widespread use of these drugs, it’s important to give safe corticoids alternatives to these patients performing drug challenges after negative prick or intradermal tests. We have diagnosed an anaphylactic reaction caused by 6-methyl-prednisolone confirmed by a positive prick test. We have confirmed that the patient tolerated methyl-prednisolone, and so we think that he was sensitized only to hemisuccinate but not to succinate esters as in other published cases. Due to the widespread use of these drugs, it’s important to give safe corticoids alternatives to these patients performing drug challenges after negative prick or intradermal tests." @default.
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- W2022910414 date "2012-02-01" @default.
- W2022910414 modified "2023-10-09" @default.
- W2022910414 title "Anaphylactic Reaction After 6-methyl-prednisolone" @default.
- W2022910414 doi "https://doi.org/10.1016/j.jaci.2011.12.522" @default.
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