Methylprednisolone acetate/prednisone
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Anaphylaxis: case report A 67-year-old woman developed anaphylaxis during corticosteroid therapy with methylprednisolone acetate and prednisone [dosages not stated]. The woman, who had a history of ankylosing spondylitis, experienced erythematous pruritic rash on her left hip after 24 hours of the administration of IM methylprednisolone acetate and lidocaine for bursitis. Within 2 days, she developed facial flushing and periorbital angioedema. The woman visited to the emergency department, and was given oral prednisone and diphenhydramine. After 5 minutes, her periorbital angioedema worsened. She also developed hypotension, vomitting, diarrhoea and had syncope. Therefore, she required epinephrine and ICU admission. Anaphylaxis was considered. Skin testings (ST) including prick test (PT) with methylprednisolone sodium succinate and prednisone, and intradermal test (ID) with methylprednisolone acetate, dexamethasone and prednisolone were found to be positive. While, ST (PT and ID) to triamcinolone acetonide, lidocaine and polyethylene glycol, and a drug provocation test to lidocaine were found to be negative. Following evaluation, she tolerated a triamcinolone acetonide hip infiltration. Based on these findings, the anaphylaxis was considered to be due to methylprednisolone acetate and prednisone. Author comment: "Reactions to two [corticosteroids], positive [corticosteroid] ST and negative [polyethylene glycol] ST suggest that this patient and reaction was due to [methylprednisolone acetate and prednisone]." "[S]he had reactions involving [methylprednisolone acetate] and prednisone." Sanchez-Valenzuela M, et al. EXCIPIENTS ASIDE, ANAPHYLAXIS TO CORTICOSTEROIDS IS A REAL THING. Annals of Allergy, Asthma and Immunology 123 (Suppl.): S67-S68, No. 5, Nov 2019. Available from: URL: 803432277 https://www.annallergy.org/issues [abstract] - USA
0114-9954/19/1778-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 9 Nov 2019 No. 1778
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