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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
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Measuring Local Anaphylaxis in Mice
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Drug or food anaphylaxis?

Catalina Gomez-Galán1,2, Bélgica Minaya-Polanco3, Jiménez-Freites Martha3

  • 1Allergy Unit, Consorci Sanitari Alt Penedès-Garraf, Barcelona, Spain.

Allergologia Et Immunopathologia
|May 9, 2025
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Summary

An infant experienced anaphylaxis to Ferplex® (iron protein succinylate) due to undetected cow's milk protein. Regulations need updating to declare food allergens in medications, preventing future infant allergic reactions.

Keywords:
adrenalineanaphylaxiscaseiniron protein succinylatepharmacovigilance

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Area of Science:

  • Allergy and Immunology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Atopic dermatitis is common in infants.
  • Early introduction of foods and medications requires careful monitoring for allergies.
  • Suspected food and drug allergies necessitate thorough evaluation.

Observation:

  • A 9-month-old infant with atopic dermatitis had an allergic reaction after the first dose of Ferplex® (iron protein succinylate) for anemia.
  • The infant was breastfed and had only consumed fruits and vegetables.
  • The reaction required emergency medical attention and epinephrine treatment.

Findings:

  • Skin prick tests and specific IgE confirmed sensitization to cow's milk and egg proteins.
  • The infant reacted to Ferplex® due to its casein content (a cow's milk protein), despite no prior ingestion.
  • The presence of succinylated casein was confirmed, but amounts were not disclosed.

Implications:

  • Pharmaceutical regulations should mandate declaration of food allergens in active ingredients and excipients.
  • Improved documentation of food history in infants is crucial for preventing allergic reactions.
  • This case highlights the risk of hidden allergens in medications for vulnerable pediatric populations.