[Hypersensitivity to glucocorticoids: reflections on a published case report sample]

Hypersensitivity reactions associated with glucocorticoid treatment are rare but well known; the purpose of this study was to identify the responsible constituent (the excipient or the glucocorticoid). 32 cases published from 1970 have been analysed. In 75 per cent of cases, the patients received the glucocorticoid (hydrocortisone and methylprednisolone principally) by the intravenous route. Clinical manifestations reported were respiratory or cutaneous, with a short interval to onset. Skin tests were performed in 20 patients, but cutaneous challenge identified an agent responsible for hypersensitivity in only three cases. The heterogeneity of the test results in these 32 cases makes it difficult to identify a unifying explanation for the reactions, or propose a therapeutic schedule.