吸入噻托溴铵后的皮肤反应：一例报告
Skin reaction to inhaled tiotropium bromide: a case report.
作者信息
Incorvaia Cristoforo, Fuiano Nicola, Megali Raffaella, Riario-Sforza Gian Galeazzo
机构信息
Department of Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy.
出版信息
J Med Case Rep. 2011 Mar 28;5:119. doi: 10.1186/1752-1947-5-119.
INTRODUCTION
Systemic reactions to inhaled drugs are rare. To the best of our knowledge, we report the first case of generalized itching related to the use of tiotropium bromide, a long acting inhaled anti-cholinergic agent commonly used to treat chronic obstructive pulmonary disease.
CASE PRESENTATION
A 78-year-old Caucasian woman was referred to our facility for allergological evaluation. Our patient had been treated twice with tiotropium for chronic obstructive pulmonary disease and had experienced an allergic reaction with itching. We performed a double-blind placebo-controlled inhalation challenge for our patient with tiotropium and a placebo. Inhalation tests yielded positive results for tiotropium and negative results for the placebo. The results of a skin prick test with tiotropium were negative.
CONCLUSIONS
These findings reveal that tiotropium may elicit immediate skin allergic reactions. The negative result from the skin test suggests that such a reaction is not immunoglobulin E-mediated.
引言
吸入药物引起的全身反应较为罕见。据我们所知，我们报告了首例与噻托溴铵使用相关的全身性瘙痒病例，噻托溴铵是一种常用于治疗慢性阻塞性肺疾病的长效吸入性抗胆碱能药物。
病例介绍
一名78岁的白种女性因过敏评估被转诊至我院。我们的患者曾两次使用噻托溴铵治疗慢性阻塞性肺疾病，并出现了伴有瘙痒的过敏反应。我们对患者进行了噻托溴铵和安慰剂的双盲安慰剂对照吸入激发试验。吸入试验结果显示噻托溴铵为阳性，安慰剂为阴性。用噻托溴铵进行皮肤点刺试验的结果为阴性。
结论
这些发现表明噻托溴铵可能引发即刻皮肤过敏反应。皮肤试验的阴性结果表明这种反应不是由免疫球蛋白E介导的。
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