Wenande E, Garvey L H
Danish Anaesthesia Allergy Centre, Allergy Clinic, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
Clin Exp Allergy. 2016 Jul;46(7):907-22. doi: 10.1111/cea.12760.
Polyethylene glycols (PEGs) or macrogols are polyether compounds widely used in medical and household products. Although generally considered biologically inert, cases of mild to life-threatening immediate-type PEG hypersensitivity are reported with increasing frequency. Nevertheless, awareness of PEG's allergenic potential remains low, due to a general lack of suspicion towards excipients and insufficient product labelling. Information on immediate-type reactions to PEG is limited to anecdotal reports, and the potential for PEG sensitization and cross-sensitization to PEGylated drugs and structurally related derivatives is likely underestimated. Most healthcare professionals have no knowledge of PEG and thus do not suspect PEG's as culprit agents in hypersensitivity reactions. In consequence, patients are at risk of misdiagnosis and commonly present with a history of repeated, severe reactions to a range of unrelated products in hospital and at home. Increased awareness of PEG prevalence, PEG hypersensitivity, and improved access to PEG allergy testing, should facilitate earlier diagnosis and reduce the risk of inadvertent re-exposure. This first comprehensive review provides practical information for allergists and other healthcare professionals by describing the clinical picture of 37 reported cases of PEG hypersensitivity since 1977, summarizing instances where PEG hypersensitivity should be considered and proposing an algorithm for diagnostic management.
聚乙二醇（PEGs）或聚环氧乙烷是广泛应用于医疗和家用产品中的聚醚化合物。尽管通常认为它们具有生物惰性，但从轻度到危及生命的速发型PEG过敏反应的病例报告频率却在不断增加。然而，由于对辅料普遍缺乏怀疑以及产品标签不足，人们对PEG致敏潜力的认识仍然很低。关于对PEG速发型反应的信息仅限于轶事报道，而且PEG致敏以及对聚乙二醇化药物和结构相关衍生物的交叉致敏可能性可能被低估了。大多数医疗保健专业人员对PEG并不了解，因此不会怀疑PEG是过敏反应的元凶。结果，患者有被误诊的风险，并且通常有在医院和家中对一系列不相关产品反复发生严重反应的病史。提高对PEG普遍性、PEG过敏的认识，并改善PEG过敏检测的可及性，应有助于早期诊断并降低意外再次接触的风险。这篇首次全面综述通过描述自1977年以来报告的37例PEG过敏病例的临床表现，总结应考虑PEG过敏的情况，并提出诊断管理算法，为过敏症专科医生和其他医疗保健专业人员提供了实用信息。
