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Ethanol-induced urticaria: elevated tryptase levels after double-blind, placebo-controlled challenge
S Emonet1, S Hogendijk, J Voegeli
1Allergy Unit, Division of Immunology and Allergy, University Hospital, Geneva, Switzerland.
Dermatology (Basel, Switzerland)
|September 10, 1998
Summary
A patient experienced chronic urticarial reactions upon alcohol consumption. Elevated serum tryptase levels after ethanol challenge aided in diagnosing this ethanol-induced urticaria.
Area of Science:
- Allergy and Immunology
- Dermatology
- Gastroenterology
Background:
- Urticarial reactions are common hypersensitivity responses.
- Alcohol consumption can trigger various adverse reactions in susceptible individuals.
- Diagnosing specific triggers for urticaria can be challenging.
Observation:
- A 48-year-old patient reported recurrent urticarial reactions exclusively after ingesting alcoholic beverages.
- Skin prick tests were negative for ethanol but positive for acetic acid, unlike controls.
- A double-blind, placebo-controlled ethanol challenge induced erythema and wheals.
Findings:
- The patient exhibited a significant increase in serum tryptase levels post-ethanol challenge, correlating with skin lesion development.
- Ethanol, not placebo, triggered the reaction, confirmed by clinical symptoms and tryptase elevation.
- Acetic acid sensitivity was noted but ethanol was the confirmed clinical trigger.
Implications:
- This case highlights the diagnostic utility of measuring serum tryptase levels in suspected ethanol-induced urticaria.
- Understanding specific triggers like ethanol is crucial for effective patient management and avoidance strategies.
- Further research may elucidate the mechanisms behind ethanol-triggered mast cell activation.