Allergy to lysozyme/egg white-containing vaginal suppositories

Area of Science:

• Allergy and Immunology
• Pharmacology
• Gynecology

Background:

• Vaginal suppositories containing lysozyme, nystatin, and tetracycline are used for suspected vaginal infections.
• Allergic reactions were observed in patients using these suppositories.

Purpose of the Study:

• To identify the causative agent of allergic reactions in patients using vaginal suppositories.
• To investigate the role of lysozyme and egg proteins in these reactions.

Main Methods:

• Clinical observation of allergic reactions.
• Skin testing (prick/scratch) for sensitization.
• Lymphocyte transformation tests (LTT) to assess T cell response.
• Serologic tests for IgE.

Main Results:

• Seven patients experienced allergic reactions (local/systemic) linked to lysozyme-containing suppositories.
• Three patients with prior egg allergy reacted to the first suppository.
• Four patients without egg allergy developed reactions after prolonged use.
• Skin tests showed sensitization to ovomucoid and lysozyme in most patients.
• Lymphocyte transformation tests revealed T cell responses to lysozyme and egg proteins in all patients, unlike controls.

Conclusions:

• Lysozyme in vaginal suppositories is responsible for allergic reactions.
• These reactions can occur in patients with pre-existing egg allergy or induce new sensitization.
• Contaminating egg white proteins in lysozyme preparations contribute to allergic responses.