[Allergic angioedema after local dental anesthesia and a hyaluronidase-containing preanesthetic injection solution]

Two patients are described who developed allergic angioedema following local anesthesia for dental surgery. Skin testing revealed that hyaluronidase from bull testes contained in one of the preparations used for local anesthesia was the responsible allergen. In both patients hyaluronidase-specific serum IgE antibodies were detected by RAST. Mammalian hyaluronidase, also called spreading factor, is believed to improve penetration of tissues by local anesthetics. It is used worldwide for this and other indications. In the presence of allergic reactions to local anesthetics the possibility of sensitization to hyaluronidase should be considered.