Anaphylactic-like reaction to hydrocortisone.

Two asthmatic patients with life-threatening allergy to intravenous hydrocortisone are described. A 21-year-old woman with chronic atopic asthma developed severe bronchospasm on 3 occasions after treatment with hydrocortisone. Allergy to hydrocortisone was only established on the third occasion. Skin prick tests with hydrocortisone (Solu-Cortef) gave a 5-mm wheal reaction and confirmed the allergy. Skin prick tests with methylprednisolone and dexamethasone elicited no allergic response. Allergy to hydrocortisone was also seen on 2 occasions in a 41-year-old man with asthma, although it was not proved by challenging him with intravenous hydrocortisone.