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Summary
Systemic reactions to adrenocorticosteroids are rare but documented. Testing confirms the glucocorticoid itself, not the vehicle, causes these reactions, especially in aspirin-sensitive asthmatics.
Area of Science:
- Pharmacology
- Immunology
- Dermatology
Background:
- Systemic reactivity to adrenocorticosteroids is a recognized clinical phenomenon.
- Over 30 cases have been reported in medical literature.
- Reactions are typically attributed to the active glucocorticoid component.
Purpose of the Study:
- To investigate the cause of systemic reactivity to adrenocorticosteroids.
- To identify specific patient populations at higher risk for such reactions.
Main Methods:
- Review of reported cases of systemic reactivity to adrenocorticosteroids.
- Analysis of skin and challenge testing results.
- Correlation of reactions with patient history, including aspirin sensitivity.
Main Results:
- Skin and challenge testing consistently identified the glucocorticoid as the causative agent in over 30 reported cases.
- The vehicle or excipient was rarely implicated as the cause of reactivity.
- Aspirin-sensitive asthmatic patients showed a potential predisposition to these reactions.
Conclusions:
- Glucocorticoids themselves are the primary cause of systemic reactivity.
- Patients with aspirin-sensitive asthma may be at increased risk for adverse reactions to adrenocorticosteroids.
- Further investigation into the mechanisms of glucocorticoid hypersensitivity is warranted.