Department of Allergy, Hospital Clinico San Carlos, Madrid, Spain.
J Investig Allergol Clin Immunol. 2010;20(6):521-3.
Local reactions to glatiramer acetate are common, but few cases of hypersensitivity reaction have been reported. We present 3 patients with multiple sclerosis who suffered immediate-type local reactions after subcutaneous injection of glatiramer acetate. Skin prick test (SPT), intradermal test (IDT), and determination of immunoglobulin (Ig) E to glatiramer acetate were performed in patients and controls (enzyme-linked immunosorbent assay). The results of SPT were all negative. Those of IDT in controls were negative at concentrations below 200 microg/mL, but positive for patients 1, 2, and 3 at 2, 20, and 200 microg/mL, respectively. Serum IgE to glatiramer acetate in patient 1 was 2.1 times higher than in the controls, whereas no differences were found between controls and patients 2 and 3. Glatiramer acetate was safely reintroduced in patients 2 and 3. The results obtained for patient 1 suggest that an IgE-mediated mechanism was probably involved. In conclusion, IDT and serum IgE determination to glatiramer acetate seem useful for identifying allergic reactions among the common local reactions induced by this drug.
局部对醋酸格拉替雷的反应很常见，但很少有报道过敏反应的病例。我们介绍了 3 例多发性硬化症患者，他们在皮下注射醋酸格拉替雷后立即出现局部反应。对患者和对照组（酶联免疫吸附试验）进行了皮肤点刺试验（SPT）、皮内试验（IDT）和免疫球蛋白（IgE）对醋酸格拉替雷的测定。SPT 的结果均为阴性。对照组 IDT 的结果在低于 200μg/ml 的浓度下均为阴性，但患者 1、2 和 3 分别在 2、20 和 200μg/ml 时为阳性。患者 1 的血清 IgE 对醋酸格拉替雷的水平比对照组高 2.1 倍，而对照组与患者 2 和 3 之间无差异。在患者 2 和 3 中安全地重新引入了醋酸格拉替雷。患者 1 的结果表明，可能涉及 IgE 介导的机制。总之，IDT 和血清 IgE 对醋酸格拉替雷的测定似乎有助于识别这种药物引起的常见局部反应中的过敏反应。
