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Anaphylactic shock following povidone
M A Gonzalo Garijo1, J A Durán Quintana, P Bobadilla González
1University Hospital Infanta Cristina, Badajoz, Spain.
The Annals of Pharmacotherapy
|January 1, 1996
Summary
Povidone, a common pharmaceutical excipient, caused a severe anaphylactic reaction in a patient. This highlights the importance of disclosing all ingredients in medications to prevent potential adverse drug events.
Area of Science:
- Pharmacology
- Immunology
- Allergy
Background:
- Povidone is a widely used excipient in pharmaceuticals, food, and cosmetics.
- While generally well-tolerated, povidone has been associated with local and systemic adverse effects.
- The immunologic properties and potential for hypersensitivity reactions to povidone in humans require further investigation.
Observation:
- A 37-year-old man with allergic rhinitis experienced anaphylaxis, including urticaria, dyspnea, and wheezing, post-intraarticular injection.
- Provocation tests identified povidone, an excipient in the injected medication, as the cause of the reaction.
- Tests for other components, including mepivacaine hydrochloride and other excipients like benzalkonium chloride and polysorbate 80, were negative.
Findings:
- Povidone was confirmed as the causative agent of the severe anaphylactic reaction.
- The exact immunologic mechanism, whether unspecific histamine release or IgE-mediated hypersensitivity, remains undetermined.
- Povidone's immunogenicity and histamine-releasing capacity are known to be dose-dependent on its molecular weight.
Implications:
- This case underscores the potential for excipients to cause significant iatrogenic adverse drug reactions.
- Healthcare providers should consider excipients as potential allergens in patients presenting with unexplained anaphylaxis.
- Full disclosure of pharmaceutical excipients is crucial for patient safety and accurate diagnosis of hypersensitivity reactions.