Scolapio James S, Ferrone Marcus, Gillham Robert A
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
JPEN J Parenter Enteral Nutr. 2005 Nov-Dec;29(6):451-3. doi: 10.1177/0148607105029006451.
We report a 53-year-old female patient with short bowel syndrome who developed urticaria after administration of cyclic parenteral nutrition (PN). The urticaria occurred 2 hours into the 12-hour nocturnal infusion and resolved completely 1 hour after discontinuation of the PN infusion. The urticaria occurred despite removing lipids from the 3-in-1 PN solution. The urticaria did not occur when the multivitamin preparation was removed from the PN. Upon rechallenge with a PN solution containing a multivitamin, the urticaria reoccurred. Prick skin testing using the multivitamin in increasing aliquots was negative. Serum tryptase and 12-hour urinary histamine level during PN infusion containing the multivitamin was unchanged compared with baseline measurements. The patient had no allergic reaction using a similar dose of an oral multivitamin. This case illustrates that allergic reactions from PN infusion may occur and that the multivitamin preparation can be the cause.
我们报告了一名53岁的短肠综合征女性患者，她在接受循环肠外营养（PN）后出现了荨麻疹。荨麻疹在夜间12小时输注开始2小时后出现，并在PN输注停止1小时后完全消退。尽管从三合一PN溶液中去除了脂质，但荨麻疹仍会出现。当从PN中去除多种维生素制剂时，荨麻疹未再出现。在用含有多种维生素的PN溶液再次激发时，荨麻疹再次出现。使用逐渐增加剂量的多种维生素进行点刺皮肤试验结果为阴性。与基线测量相比，在含有多种维生素的PN输注期间，血清类胰蛋白酶和12小时尿组胺水平没有变化。该患者使用类似剂量的口服多种维生素时没有过敏反应。这个病例表明，PN输注可能会引起过敏反应，并且多种维生素制剂可能是原因。
