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IgE-mediated allergy to chlorhexidine.

Lene Heise Garvey1, Mogens Krøigaard, Lars K Poulsen

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Summary

Chlorhexidine allergy is confirmed as IgE-mediated. Measuring specific IgE and histamine release aids in diagnosing this allergy, supporting skin test results in patients with suspected reactions.

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Area of Science:

  • Allergy and Immunology
  • Pharmacology
  • Clinical Medicine

Background:

  • Since 1999, the Danish Anesthesia Allergy Centre has investigated chlorhexidine allergy.
  • Clinical history suggestive of chlorhexidine allergy prompted patient inclusion.

Purpose of the Study:

  • To determine if immunoglobulin E (IgE) and histamine release measurements confirm an IgE-mediated mechanism for chlorhexidine allergy.
  • To evaluate diagnostic adjuncts for chlorhexidine allergy.

Main Methods:

  • Twenty-two patients with suspected chlorhexidine allergy were assessed.
  • Skin tests, tryptase measurements, and retrospective serum analysis for IgE and histamine release were performed.
  • Passive sensitization assays were utilized for histamine release testing.

Main Results:

  • Of 12 skin test-positive patients, 11 showed IgE to chlorhexidine and 7 had positive histamine release.
  • No skin test-negative patients exhibited specific IgE or positive histamine release.
  • Skin test-positive patients were older, predominantly male, and experienced reactions more often during urologic surgery.

Conclusions:

  • This study validates that chlorhexidine allergy is IgE-mediated.
  • Measurement of specific IgE and histamine release are effective adjuncts to skin testing for diagnosing chlorhexidine allergy.
  • These tests support clinical diagnosis in patients with suspected chlorhexidine allergy.