Lee-Wong Mary, McClelland Suzanne, Chong Kaman, Fernandez-Perez Evans R
Division of Clinical Immunology and Allergy, Department of Medicine, Beth Israel Medical Center, New York, New York 10003, USA.
Allergy Asthma Proc. 2006 May-Jun;27(3):265-8. doi: 10.2500/aap.2006.27.2854.
Allergic reactions and systemic desensitization to corticosteroids have been documented rarely in English language literature. These reactions appear more often when the agent is applied topically and may lead to dangerous complications in patients if administered i.v. Therefore, the safety and efficacy of using an i.v. corticosteroid for desensitization in a patient who has a history of allergy to corticosteroid must be weighed carefully, especially when the aim of its use is to prevent an allergic reaction from a second drug. We report a case of successful systemic hydrocortisone desensitization in a patient with radiocontrast-induced anaphylactoid reaction and corticosteroid allergy. Sensitization to corticosteroids was determined through skin testing. The patient was desensitized to hydrocortisone and premedicated with hydrocortisone and diphenhydramine and subsequently underwent cardiac catheterization with radiocontrast without adverse reaction.
英文文献中鲜有关于皮质类固醇过敏反应和全身脱敏的记载。这些反应在局部应用该药物时更常出现,如果静脉注射,可能会给患者带来危险的并发症。因此,对于有皮质类固醇过敏史的患者,静脉注射皮质类固醇进行脱敏的安全性和有效性必须仔细权衡,尤其是当使用它的目的是预防第二种药物引起的过敏反应时。我们报告一例对放射性造影剂诱发类过敏反应和皮质类固醇过敏的患者成功进行全身氢化可的松脱敏的病例。通过皮肤试验确定对皮质类固醇的致敏情况。该患者对氢化可的松进行了脱敏,并预先使用氢化可的松和苯海拉明进行预处理,随后接受了含放射性造影剂的心脏导管插入术,未出现不良反应。