Kradjan W A, Lakshminarayan S
Am J Hosp Pharm. 1981 Jul;38(7):1031-3.
Problems with determining hypersensitivity to aminophylline, ethylenediamine, and theophylline with intradermal skin tests and patch tests are reported in three patients. Three patients were tested with intradermal injections of 0.9% sodium chloride, 1% aminophylline, 1% ethylenediamine, and 0.5% theophylline following apparent allergic reactions to aminophylline. Patch testing using hydrophilic ointment base, 1% aminophylline, 1% ethylenediamine, and 0.5% theophylline was also done. All three patients had no reaction to intradermal sodium chloride or theophylline; all patch tests were negative. The first patient reacted to ethylenediamine strongly and to aminophylline more weakly; punch biopsy of the ethylenediamine reaction site showed a direct toxic effect with no allergic component. Punch biopsy of the aminophylline site showed a typical hypersensitivity reaction. Two concentrations (0.5% and 1.0%) of ethylenediamine injection were used to test the second patient, and he reacted to both concentrations but not to any other injections. His positive reactions contained blisters rather than the typical wheal-and-flare reaction of hypersensitivity. The third patient had similar responses including reactions to 0.5% and 0.1% ethylenediamine (he was not tested with 1% ethylenediamine). Skin testing may be of value in predicting aminophylline or ethylenediamine allergy, but the nonspecific toxic effect of ethylenediamine makes interpretation difficult.
三名患者中报告了通过皮内皮肤试验和斑贴试验确定对氨茶碱、乙二胺和茶碱过敏的问题。三名患者在出现对氨茶碱的明显过敏反应后，接受了皮内注射0.9%氯化钠、1%氨茶碱、1%乙二胺和0.5%茶碱的测试。还进行了使用亲水软膏基质、1%氨茶碱、1%乙二胺和0.5%茶碱的斑贴试验。所有三名患者对皮内注射氯化钠或茶碱均无反应；所有斑贴试验均为阴性。第一名患者对乙二胺反应强烈，对氨茶碱反应较弱；对乙二胺反应部位进行的打孔活检显示为直接毒性作用，无过敏成分。对氨茶碱部位进行的打孔活检显示为典型的过敏反应。使用两种浓度（0.5%和1.0%）的乙二胺注射液对第二名患者进行测试，他对两种浓度均有反应，但对其他任何注射均无反应。他的阳性反应包含水疱，而非过敏的典型风团和潮红反应。第三名患者有类似反应，包括对0.5%和0.1%乙二胺的反应（未对其进行1%乙二胺的测试）。皮肤试验在预测氨茶碱或乙二胺过敏方面可能有价值，但乙二胺的非特异性毒性作用使结果解读困难。
