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Anaphylactic shock after skin test with phytohaemoagglutinin
D Schiavino1, E Nucera, F Murzilli
1Department of Allergology, Catholic University of Rome, Italy.
Allergy
|April 1, 1992
Summary
A severe allergic reaction to phytohaemoagglutinin (PHA) was observed in a patient with gastrointestinal candidosis. This suggests a potential Type I immunoreaction to PHA, previously undocumented in medical literature.
Area of Science:
- Immunology
- Allergy Research
- Gastroenterology
Background:
- A 26-year-old female patient presented with an 8-month history of gastrointestinal candidosis.
- The study aimed to investigate the patient's cell-mediated immunity.
Observation:
- An immediate, severe hypersensitivity reaction occurred post-intradermal injection of phytohaemoagglutinin (PHA), mixed monilia, mixed tricophyton, and purified protein derivative (PPD).
- Symptoms included extensive wheal and flare, eyelid edema, and respiratory distress, necessitating emergency resuscitation.
- Despite prompt medical intervention with adrenaline, corticosteroids, and antihistamines, the patient experienced a collapse before recovering.
Findings:
- Immune testing revealed elevated total IgE levels (72 KU/L).
- Specific IgE assays for Candida were negative.
- An in vitro lymphocyte transformation test using PHA was positive, indicating cellular immune response.
Implications:
- The observed reaction and positive PHA lymphocyte test suggest a possible Type I allergic immunoreaction to PHA.
- This represents a potentially novel allergic response, as such a reaction to PHA has not been previously reported in the literature.
- Further investigation into IgG STS is warranted to fully characterize the immune response.