Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, 47 Hawthorn St, Coburg, Carlton, Australia.
Australas J Dermatol. 2010 Feb;51(1):49-51. doi: 10.1111/j.1440-0960.2009.00593.x.
Hyaluronidase is a bovine or ovine testicular protein that is used as an adjunct to co-administered medicaments and fluids to enhance their dispersion and absorption through the degradation of hyaluronan. While it is a known potential allergen, there are few reports of hyaluronidase hypersensitivity. A 56-year-old lady presented 8 hours post glaucoma surgery with ipsilateral lacriminorrhoea, periorbital erythema, oedema, proptosis, pruritus and conjunctival chemosis. Right ocular motility was restricted and visual acuity was reduced. The reaction settled with oral corticosteroids and antihistamines. Hyaluronidase allergy was confirmed on skin prick testing. Hyaluronidase allergy is rare. In the few cases reported, reactions occurred at various doses and were acute (intraoperative), early (within hours), intermediate (within days) or delayed (within weeks). Anaphylaxis has also been described. Primary sensitization appears to be a prerequisite for most reactions. The variability in onset of symptoms and the response to skin testing would suggest that type I and type IV hypersensitivity may both contribute to this response. In this case, the timing fitted with a late phase type 1 reaction. This case shows that despite being less common than haemorrhage for acute reactions and infection for delayed reactions, allergy can account for orbital inflammation following ophthalmic surgery.
透明质酸酶是一种牛或羊睾丸蛋白，用作与联合给予的药物和液体的辅助剂，以通过透明质酸的降解增强其分散和吸收。虽然它是一种已知的潜在过敏原，但很少有关于透明质酸酶过敏的报告。一位 56 岁的女士在青光眼手术后 8 小时出现同侧流泪、眶周红斑、水肿、眼球突出、瘙痒和结膜水肿。右眼运动受限，视力下降。反应通过口服皮质类固醇和抗组胺药得到缓解。皮肤点刺试验证实对透明质酸酶过敏。透明质酸酶过敏很少见。在报告的少数情况下，反应发生在不同剂量，且为急性（手术中）、早期（数小时内）、中期（数天内）或延迟（数周内）。也有描述过过敏反应。初次致敏似乎是大多数反应的先决条件。症状发作的可变性和皮肤试验的反应表明，I 型和 IV 型超敏反应可能都与这种反应有关。在这种情况下，时间与迟发型 1 型反应相符。该病例表明，尽管过敏反应在眼科手术后的眶内炎症中不如急性反应的出血和延迟反应的感染常见，但过敏可以导致眶内炎症。
