Anaphylactic shock reaction to dibutyl-phthalate-containing capsules

Area of Science:

• Pharmacology
• Allergology
• Toxicology

Background:

• Anaphylaxis is a severe allergic reaction that can be triggered by various substances.
• Herbal medications are increasingly used for common ailments, including respiratory tract infections.
• Auxiliary materials in drug formulations are rarely considered as potential allergens.

Purpose of the Study:

• To investigate the cause of anaphylactic shock in a patient using a herbal mucosecretolytic agent.
• To identify the specific component responsible for the allergic reaction.
• To highlight the role of auxiliary materials in drug-induced anaphylaxis.

Main Methods:

• Case report of a patient experiencing anaphylaxis after ingesting Gelomyrtol forte.
• Allergen-specific skin prick testing with individual components of the herbal product.
• Identification of the causative agent through positive skin test results.

Main Results:

• The patient developed symptoms of anaphylaxis, including itching, urticaria, and respiratory distress, shortly after taking the medication.
• Skin prick tests identified dibutyl phthalate as the allergen.
• Dibutyl phthalate, a plasticizer used in capsule coatings, elicited a strong positive reaction.

Conclusions:

• Auxiliary materials, such as dibutyl phthalate, can act as triggers for anaphylactic reactions.
• Healthcare providers should consider inactive ingredients when diagnosing drug-induced anaphylaxis.
• Further investigation into the allergenicity of pharmaceutical excipients is warranted.