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Systemic allergic reactions to corticosteroids.

M Murrieta-Aguttes1, V Michelen, F Leynadier

  • 1Centre D'Allergie, Hopital Rothschild, Paris, France.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|January 1, 1991
PubMed
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Severe allergic reactions to corticosteroid injections, though rare, can occur. Comprehensive skin testing for corticosteroids and their components is recommended for patients experiencing anaphylaxis.

Area of Science:

  • Immunology
  • Pharmacology

Background:

  • Allergic anaphylactic (Type I) reactions to corticosteroids are infrequently documented.
  • This study reviews existing literature and presents two cases of anaphylaxis following corticosteroid injections.

Observation:

  • Two patients experienced severe anaphylaxis post-corticosteroid injection.
  • Skin testing revealed sensitivity to specific corticosteroids and/or carboxymethylcellulose in one patient.
  • The second patient showed positive skin tests to multiple corticosteroids and suxamethonium.

Findings:

  • One patient was sensitive to corticosteroid preparations containing carboxymethylcellulose and pure carboxymethylcellulose.
  • The second patient demonstrated hypersensitivity to hydrocortisone, hydrocortisone sodium succinate, methylprednisolone sodium succinate, and suxamethonium.

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  • Control subjects tested with the same agents showed no positive reactions, validating patient-specific sensitivities.

    • Implications:

    • Comprehensive skin testing is crucial for patients with severe systemic reactions to injectable corticosteroids.
    • Testing should include a wide range of corticosteroids and potential excipients like carboxymethylcellulose.
    • Identifying specific allergens can guide safer treatment alternatives and prevent future anaphylactic events.