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Sulfite-induced urticaria

J Belchi-Hernandez1, J F Florido-Lopez, J L Estrada-Rodriguez

  • 1Department of Allergy, La Paz Hospital, Madrid, Spain.

Annals of Allergy
|September 1, 1993
PubMed
Summary
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Metabisulfite sensitivity can cause allergic reactions like urticaria (hives) and angioedema. This case study details a patient experiencing these symptoms after consuming sulfites, highlighting the need for awareness.

Area of Science:

  • Allergy and Immunology
  • Food Science
  • Dermatology

Background:

  • Sulfites, including metabisulfites, are common food additives with increasing reports of sensitivity.
  • Adverse reactions can manifest as asthma or other symptoms in both asthmatic and nonasthmatic individuals.

Observation:

  • A patient experienced recurrent urticaria, angioedema, and dysphonia without asthma after ingesting sulfite-containing foods and drinks.
  • Oral challenge with potassium metabisulfite confirmed the induction of urticaria, facial swelling, and rhinorrhea.

Findings:

  • Prick and intradermal tests for sulfite sensitivity were negative.
  • Repeated oral challenges with potassium metabisulfite consistently reproduced symptoms.
  • Prophylactic administration of sodium cromolyn and cyanocobalamin showed potential in mitigating reactions, though the pathogenic mechanism remains unclear.

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Implications:

  • This case highlights metabisulfite as a potential trigger for urticaria and angioedema in sensitive individuals.
  • Further research is needed to elucidate the precise mechanisms underlying non-asthmatic sulfite hypersensitivity.
  • Clinicians should consider sulfite sensitivity in patients presenting with unexplained urticarial syndromes.