Volume 4 Supplement 3

6th Drug Hypersensitivity Meeting (DHM 6)

Open Access

Hypersensitivity to glucorticoids in children

  • Tina Vesel1,
  • Mira Šilar2,
  • Meta Accetto1,
  • Uroš Krivec3,
  • Simona Žitnik1,
  • Vesna Glavnik1,
  • Anja Koren Jeverica1,
  • Mitja Košnik4,
  • Peter Korošec2 and
  • Tadej Avèin1
Clinical and Translational Allergy20144(Suppl 3):P143

https://doi.org/10.1186/2045-7022-4-S3-P143

Published: 18 July 2014

Introduction

Immediate hypersensitivity to glucocorticoids is rarely reported, especially in children. Assessment of cross-reactivity after immediate hypersensitivity to intravenous methylprednisolone (MP) usually shows a tolerance to at least one of the alternatives, e.g. MP tablet, hydrocortisone (HC) or dexamethasone (DX).

Methods

We present 8 children with suspected hypersensitivity reaction after parenteral MP (6 children), DX inhalation (1 child) and inhafluticasone propionate (FL) (1 child). Prick and intradermal skin testing with MP, HC, DX and FL were performed. In case of negative skin tests provocation tests were performed. Basophil activation test (flow cytometry analyses of basophil CD63 surface expression induced by different concentrations of MP, HC, DX and FL (333, 33,3 and 3,33 mcg/ml)) was performed in all patients and in ten controls who tolerated those drugs. Stimulation index (SI) >2 was considered positive.

Results

All children (5 boys, 3 girls) were atopics and were exposed to various glucocorticoids before systemic hypersensitivity reaction. In 7 children allergy to culprit glucocorticoid was confirmed. 6 children had positive results of either skin testis or provocation test with three or four glucocorticoids and 2 children to MP only. Four children had also positive results of either skin testing or provocation test to FL. In three children positive provocation test after negative skin test confirmed allergy to glucocorticoid. BAT was positive in 6 children: 5 MP, 3 HC, 5 DX, 3 FL. One child with positive skin test to MP had negative BAT. One child was BAT non-responder. One child who tolerated FL had positive BAT to FL. BAT to MP, DX, HC was negative in all ten controls (SI<1). However, BAT with nasal drops of FL was positive in 3 controls (2<si).

Authors’ Affiliations

(1)
Department of Allergology, Rheumatology and Clinic, University Children's Hospital, University Medical Center
(2)
Laboratory for Clinical Immunology and Molecular, University Clinic of Respiratory and Allergic Diseases
(3)
University Medical Center, Ljubljana, Department of Pulmonology, University Children's Hospital
(4)
Department of Allergology, University Clinic of Respiratory and Allergic Diseases

Copyright

© Vesel et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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