Department of Clinical Immunology and Allergology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Republic of Armenia.
Iran J Allergy Asthma Immunol. 2020 Oct 18;19(5):545-549. doi: 10.18502/ijaai.v19i5.4472.
Sometimes allergic reactions caused by various food allergens often hidden in the composition of medications can mistakenly be diagnosed as drug allergies. Such reactions can especially be unexpected if antihistamines-virtually designed to treat allergy symptoms, are imitated. We present the case of a 37-year-old female patient with cutaneous allergic reaction initially diagnosed as drug allergy to desloratadine/aerius, a desloratadine-containing antihistamine medication. The diagnostic search began with the anamnestic data of the patient about an allergy to cooked corn in her childhood, current seasonal allergic rhinitis, and hand dermatitis probably related to her professional activity. Skin tests and additional laboratory examinations led to diagnosing corn/maize allergy manifested as both food (mainly) and pollen allergy. Besides, it was concluded that hand dermatitis also can becaused by cornstarch contained in medical gloves. Finally, based on the results of a drug challenge test performed with two desloratadine-containing medications-desloratadine/aerius containing cornstarch as an excipient and desloratadine/lordestinenot containing cornstarch, the causative significance of corn was confirmed. Thus, the initial diagnosis of drug allergy was changed to that of food allergy.
有时，由各种食物过敏原引起的过敏反应常常隐藏在药物成分中，可能会被误诊为药物过敏。如果模仿抗组胺药——实际上是为了治疗过敏症状而设计的，那么这种反应尤其可能出人意料。我们介绍了一位 37 岁女性患者的病例，她最初被诊断为对含有地氯雷他定的抗组胺药 Desloratadine/Aerius（地氯雷他定）过敏，但实际上她患有皮肤过敏反应。诊断研究从患者关于童年时对熟玉米过敏、当前季节性过敏性鼻炎和可能与职业相关的手部皮炎的病史数据开始。皮肤测试和其他实验室检查导致诊断出玉米/玉米过敏，表现为食物（主要）和花粉过敏。此外，还得出结论，手部皮炎也可能是由医用手套中含有的玉米淀粉引起的。最后，基于对含有玉米淀粉作为赋形剂的地氯雷他定/ Aerius 和不含玉米淀粉的地氯雷他定/ Lordestinen 两种含地氯雷他定药物进行的药物挑战测试的结果，证实了玉米的致病意义。因此，最初的药物过敏诊断被更改为食物过敏。
