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Severe hypersensitivity reactions to corticosteroids in children
Amit Nahum1, Ben Zion Garty, Nufar Marcus
1Department of Pediatrics, Kaplan Medical Center, Rehovot, Hebrew University, Hadassah Medical School Jerusalem, Israel.
Pediatric Emergency Care
|May 16, 2009
Summary
Methylprednisolone sodium-succinate can cause allergic reactions in children, mimicking asthma exacerbations. Early recognition is crucial for proper diagnosis and management of these corticosteroid-induced hypersensitivity reactions.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pharmacology
- Respiratory Medicine
Background:
- Hypersensitivity reactions to corticosteroids are uncommon but can be severe.
- Methylprednisolone sodium-succinate is a commonly used intravenous corticosteroid in pediatric emergency settings.
- Distinguishing drug reactions from underlying conditions like asthma exacerbations can be challenging.
Observation:
- Three pediatric patients with asthma experienced hypersensitivity reactions after receiving intravenous methylprednisolone sodium-succinate.
- Two patients showed positive skin prick test results specifically to methylprednisolone sodium-succinate.
- Skin prick tests were negative for other corticosteroids and the succinate ester in these patients.
Findings:
- Methylprednisolone sodium-succinate can induce anaphylactic/anaphylactoid reactions in children.
- Skin prick testing can help identify specific corticosteroid hypersensitivity.
- Delayed skin testing in one patient yielded negative results.
Implications:
- Clinicians should maintain a high index of suspicion for corticosteroid-induced hypersensitivity in children presenting with acute symptoms.
- Prompt recognition and diagnosis are vital to avoid misattributing drug reactions to primary conditions.
- Awareness of potential methylprednisolone sodium-succinate hypersensitivity is particularly important in pediatric asthma management.
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