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Metabisulfite sensitivity and local dental anesthesia
H J Schwartz1, I A Gilbert, K A Lenner
1Department of Medicine, University Hospitals of Cleveland, Ohio.
Annals of Allergy
|February 1, 1989
Summary
Sulfite sensitivity can cause severe allergic reactions like hives and breathing difficulties after dental procedures. A provocation test confirmed metabisulfite allergy weeks later.
Area of Science:
- Allergy and Immunology
- Anesthesiology
- Toxicology
Background:
- Local anesthetics, commonly used in dentistry, can contain sulfites as preservatives.
- Sulfite sensitivity is a known adverse reaction, but its presentation can vary.
- Acute airway obstruction and urticaria are potential allergic manifestations.
Observation:
- A patient experienced urticaria and acute airway obstruction immediately following local anesthesia administration.
- The patient recovered from the acute event.
- Weeks after recovery, a parenteral provocation test was performed.
Findings:
- The parenteral provocation test yielded a positive result specifically for metabisulfite.
- This confirmed sulfite sensitivity as the underlying cause of the patient's reaction.
- The reaction was linked to the metabisulfite preservative in the local anesthetic.
Implications:
- Highlights the importance of considering sulfite sensitivity in patients presenting with unexplained allergic reactions post-local anesthesia.
- Suggests that metabisulfite preservatives in local anesthetics can trigger severe reactions.
- Emphasizes the utility of provocation testing for diagnosing sulfite sensitivity, even weeks after the initial event.