Dumond P, Franck P, Morisset M, Sainte Laudy J, Kanny G, Moneret-Vautrin D A
Department of Internal Medicine, Clinical Immunology and Allergology University Hospital, 29 avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex.
Eur Ann Allergy Clin Immunol. 2009 Dec;41(6):171-6.
Carboxymethylcellulose (CMC) is used extensively in the pharmaceutical and food industries on account of its various properties. Anaphylactic reactions are rare. It has been reported principally after intra-articular infiltration of sustained-release corticosteroids containing CMC and, very rarely, after barium enema.
A case of pre-lethal anaphylactic shock after barium enema was studied by prick-test, intra-dermal reaction (IDR), leukocyte histamine release test (LHRT), basophil activation test (BAT), cystein-leukotriene release test (CAST) and dot-blot analysis.
IDR to CMC was positive at a concentration of 10 microg/ml. BAT and CAST were positive. Specific IgE were identified using dot-blot analysis.
This is the third report of CMC-specific IgE and the second of anaphylaxis to CMC associated with a barium suspension in contact with GI tract mucosa. CMC as an excipient in medicinal products may therefore be a risk factor for severe anaphylaxis after injection or following contact with GI tract mucosa. Sensitization and allergic reactions by CMC in food additives have to be considered.
羧甲基纤维素（CMC）因其多种特性而在制药和食品工业中广泛使用。过敏反应罕见。主要报道于含CMC的缓释皮质类固醇关节腔内注射后，极罕见于钡剂灌肠后。
通过点刺试验、皮内反应（IDR）、白细胞组胺释放试验（LHRT）、嗜碱性粒细胞活化试验（BAT）、半胱氨酰白三烯释放试验（CAST）和斑点印迹分析，对1例钡剂灌肠后发生致死性过敏休克的病例进行研究。
对浓度为10微克/毫升的CMC进行IDR试验呈阳性。BAT和CAST试验呈阳性。通过斑点印迹分析鉴定出特异性IgE。
这是关于CMC特异性IgE的第三篇报道，也是第二篇与接触胃肠道黏膜的钡剂悬浮液相关的CMC过敏反应报道。因此，CMC作为药品中的辅料，在注射后或接触胃肠道黏膜后可能是严重过敏反应的危险因素。必须考虑食品添加剂中CMC引起的致敏和过敏反应。
