Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Department of Dermatology and Allergy, Allergy Clinic, Herlev and Gentofte Hospital, Hellerup, Denmark.
Clin Exp Allergy. 2021 Mar;51(3):463-470. doi: 10.1111/cea.13822. Epub 2021 Jan 15.
Polyethylene glycols (PEGs) are widely used as excipients in drugs, cosmetics and household products. Immediate-type allergy to PEGs including anaphylaxis is rare. The recent introduction of the mRNA-based COVID-19 vaccines has led to an increased focus on PEG as a possible culprit of allergic reactions to the vaccines. A low awareness of the allergenic potential of PEG among consumers, manufacturers and doctors leads to under-diagnosis and under-reporting of allergy to PEGs, putting patients at risk of repeated severe reactions.
To investigate clinical manifestations, time to diagnosis and impact of a PEG allergy diagnosis on the daily life of patients diagnosed with allergy to PEG from 2010 to 2019.
Ten patients diagnosed with allergy to PEG were included. Detailed clinical history was obtained, and allergy investigations had been performed at the time of diagnosis. All patients were contacted and asked to retrospectively complete a questionnaire about causes and impact on daily life of an allergy to PEG, scored on a likert scale (0-10) before and after diagnosis.
Eight patients had experienced at least one anaphylactic reaction requiring adrenaline treatment. Anaphylaxis was primarily caused by antibiotic/analgesic tablets, depot-steroids, antacids and laxatives. Seven patients reported repeated reactions before diagnosis (median 3, range 2-6). Median time from first reaction to diagnosis was 20 months (range 2-120). None of the patients experienced severe allergic reactions after the diagnosis. Median likert score of the impact on daily life before diagnosis was 7 compared with 4 after diagnosis.
The clinical manifestations of PEG allergy are often dramatic. Improved awareness about the clinical presentation and common culprits, clear product labelling and a standardized nomenclature is needed to ensure the timely diagnosis of PEG allergy to prevent repeated anaphylactic reactions with severe impact on patients' lives.
聚乙二醇（PEGs）作为药物、化妆品和家用产品中的赋形剂被广泛应用。对 PEGs 的即刻型过敏反应，包括过敏反应，较为罕见。由于最近推出了基于 mRNA 的 COVID-19 疫苗，PEG 作为疫苗过敏反应的可能元凶，受到了更多关注。由于消费者、制造商和医生对 PEG 的致敏潜力认识不足，导致对 PEG 过敏的诊断不足和漏报，使患者面临反复发生严重过敏反应的风险。
调查 2010 年至 2019 年间，诊断为 PEG 过敏的患者的临床表现、诊断时间以及 PEG 过敏诊断对日常生活的影响。
纳入 10 名诊断为 PEG 过敏的患者。详细采集临床病史，并在诊断时进行过敏调查。所有患者均被联系并要求回顾性地完成一份关于 PEG 过敏原因及其对日常生活影响的问卷，在诊断前后使用李克特量表（0-10 分）进行评分。
8 名患者至少经历过一次需要肾上腺素治疗的过敏反应。过敏反应主要由抗生素/镇痛药片、长效类固醇、抗酸剂和泻药引起。7 名患者在诊断前报告了反复反应（中位数 3 次，范围 2-6 次）。从首次反应到诊断的中位时间为 20 个月（范围 2-120 个月）。诊断后，无患者发生严重过敏反应。诊断前对日常生活影响的中位评分是 7 分，诊断后是 4 分。
PEG 过敏的临床表现通常很严重。需要提高对临床表现和常见元凶的认识，进行清晰的产品标签和标准化命名，以确保及时诊断 PEG 过敏，防止因严重影响患者生活而反复发生过敏反应。
