Rival-Tringali A-L, Gunera-Saad N, Berard F, Chambost V, Roziere A, Guillot-Pouget I, Nicolas J-F
Allergologie et immunologie clinique, 5F centre hospitalier Lyon-Sud, hospices civils de Lyon, Pierre-Bénite cedex, France.
Ann Dermatol Venereol. 2008 May;135(5):402-6. doi: 10.1016/j.annder.2007.11.032. Epub 2008 Apr 18.
Carboxymethylcellulose is a high-molecular-weight polysaccharide molecule used as a binding agent, for coating molecules and to increase the viscosity of formulations. It is present in a large number of pharmaceutical products but is also found in food and cosmetics.
CASE-REPORT: We report two cases of patients who presented anaphylactic reactions immediately after localised corticosteroid injections; intra-articular for the first and intralesional for the second. Allergological testing for different corticosteroids and carboxymethylcellulose by means of prick-tests and intradermal testing indicated that the immediate hypersensitivity reaction was caused by the excipient, carboxymethylcellulose. The excellent safety of oral reintroduction of carboxymethylcellulose in a pharmaceutical preparation in these two patients confirmed that this large molecule is not absorbed through the digestive system.
The avoidance list of products containing carboxymethylcellulose could be greatly reduced and limited to only injectable pharmaceutical preparations containing carboxymethylcellulose and to oral contrast media containing large quantities of carboxymethylcellulose.
羧甲基纤维素是一种高分子量多糖分子，用作粘合剂、包衣分子以及增加制剂的粘度。它存在于大量药品中，但也见于食品和化妆品中。
我们报告两例患者，他们在局部注射皮质类固醇后立即出现过敏反应；第一例为关节内注射，第二例为皮损内注射。通过点刺试验和皮内试验对不同皮质类固醇和羧甲基纤维素进行变应原检测表明，速发型超敏反应是由辅料羧甲基纤维素引起的。这两名患者口服重新引入含羧甲基纤维素的药物制剂时安全性良好，证实这种大分子不会通过消化系统吸收。
含有羧甲基纤维素的产品的避免清单可以大幅缩减，仅限于含羧甲基纤维素的注射用药物制剂以及含大量羧甲基纤维素的口服造影剂。
