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Anaphylaxis to oral furosemide
J Domínguez-Ortega1, J C Martínez-Alonso, C Domínguez-Ortega
1Allergy Unit, Hospital Virgen de la Concha, Zamora, Spain. jdort@mixmail.com
Allergologia Et Immunopathologia
|December 13, 2003
Summary
Furosemide, a common diuretic, can cause rare but severe allergic reactions like anaphylaxis. This case highlights potential cross-reactivity between furosemide and sulfonamide antibiotics, suggesting further allergy testing may be needed.
Area of Science:
- Allergy and Immunology
- Pharmacology
- Dermatology
Background:
- Furosemide, a widely prescribed loop diuretic, belongs to the non-aromatic sulfonamide class.
- While rare, type-1 allergic reactions to furosemide can occur, but cross-reactivity with other sulfonamides is not well-established.
Observation:
- A 24-year-old woman experienced anaphylaxis (oral itching, urticaria, angioedema, dyspnea, hypotension) 10 minutes after taking furosemide.
- Initial skin prick tests for furosemide were negative.
- Intradermal skin tests were positive for both furosemide and sulfamethoxazole (a sulfonamide antibiotic).
Findings:
- The case demonstrates a potential IgE-mediated hypersensitivity reaction to furosemide.
- Positive intradermal tests suggest possible cross-reactivity between non-aromatic sulfonamides (furosemide) and antimicrobial sulfonamides (sulfamethoxazole).
Implications:
- This case underscores that furosemide can induce severe allergic reactions, including anaphylaxis.
- The findings suggest a need for caution and potentially further diagnostic testing (e.g., oral challenge) in patients with sulfonamide hypersensitivity.
- Understanding cross-reactivity is crucial for managing drug allergies and ensuring patient safety.