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Hypersensitivity to ketoconazole

P González-Delgado1, F Florido-Lopez, B Saenz de San Pedro

  • 1Sección de Alergia, Hospital Ciudad de Jaén, Spain.

Annals of Allergy
|October 1, 1994
PubMed
Summary
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A patient developed a severe allergic reaction, including urticaria and angioedema, after taking ketoconazole. Diagnostic tests confirmed a type I hypersensitivity to this antifungal medication.

Area of Science:

  • Clinical Immunology
  • Dermatology
  • Pharmacology

Background:

  • Ketoconazole is an antifungal medication used to treat various infections.
  • Hypersensitivity reactions to medications can range from mild to severe.

Observation:

  • A patient presented with generalized urticaria and facial angioedema after oral ketoconazole administration.
  • Skin prick tests and oral challenge with ketoconazole were positive.
  • In vitro studies showed positive histamine release using a ketoconazole-human serum albumin conjugate.

Findings:

  • The diagnostic findings suggest a type I hypersensitivity reaction to ketoconazole.
  • Radioallergosorbent test (RAST) did not detect significant IgE antibodies to ketoconazole.
  • Skin tests with other imidazole agents (metronidazole, ornidazole, fluconazole) were negative, indicating specific sensitivity to ketoconazole.

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Implications:

  • Skin prick tests and in vitro histamine release assays are valuable tools for diagnosing ketoconazole hypersensitivity.
  • This case highlights the importance of considering drug-induced hypersensitivity in patients presenting with allergic symptoms after antifungal use.
  • Identifying specific drug allergies is crucial for patient safety and guiding future treatment choices.