Children's Hospital & Medical Center, 8200 Dodge St., Omaha, NE 68114, USA.
JPEN J Parenter Enteral Nutr. 2012 Jan;36(1):117-21. doi: 10.1177/0148607111399288. Epub 2011 Sep 30.
A case report of a 15-year-old adolescent male who developed a hypersensitivity reaction to a parenteral nutrition (PN) solution containing multivitamins (MVI) is presented. Within 30 minutes after initiation of PN and lipids, the patient developed a total-body pruritic urticarial rash that resolved after discontinuation of the infusions and administration of diphenhydramine. Rechallenge with the same PN solution excluding heparin, as well as lipids, resulted in a similar urticarial reaction that also resolved within 30 minutes after discontinuation of the infusions and administration of diphenhydramine. Another rechallenge with a solution containing dextrose and amino acids at the same concentrations contained in the original PN solution did not elicit an allergic reaction, whereas addition of MVI to the dextrose and amino acids resulted in a similar allergic reaction 20 minutes after the start of the infusion. It was determined that the MVI component of the PN was the most likely causative agent of this patient's urticarial reaction.
现报道 1 例 15 岁青少年男性患者，在输入含有多种维生素（MVI）的肠外营养（PN）溶液后发生过敏反应。在开始输入 PN 和脂肪乳剂后 30 分钟内，患者出现全身性瘙痒性荨麻疹样皮疹，在停止输液和给予苯海拉明后皮疹消退。再次输入不含肝素的相同 PN 溶液以及脂肪乳剂时，患者出现类似的荨麻疹反应，在停止输液和给予苯海拉明后 30 分钟内也消退了。再次输入含有与原始 PN 溶液中相同浓度葡萄糖和氨基酸的溶液时并未引起过敏反应，而在葡萄糖和氨基酸中添加 MVI 后 20 分钟开始输液时则出现类似的过敏反应。因此，PN 中的 MVI 成分极有可能是导致该患者荨麻疹反应的原因。
