Patterson D L, Yunginger J W, Dunn W F, Jones R T, Hunt L W
Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota.
Ann Allergy Asthma Immunol. 1995 Feb;74(2):163-6.
Allergic reactions to various corticosteroids are rare but have been reported previously.
We wished to determine the etiology of an anaphylactic reaction in a patient who had received intracutaneous Kenalog (triamcinolone acetonide).
Skin testing and serologic testing for allergen-specific IgE antibodies was performed for triamcinolone acetonide, its individual components, and three other corticosteroid preparations in both the patient and six other nonallergic persons.
The patient had positive skin tests to only the carboxymethylcellulose component of triamcinolone acetonide. He had negative skin test reactions to three other steroid preparations which did not contain carboxymethylcellulose. Specific IgE antibodies to carboxymethylcellulose were also elevated by immunoassay and immunoblotting. Control patients had negative skin tests to triamcinolone acetonide, its components, and three other corticosteroid preparations, and their sera lacked significant specific IgE antibodies to these materials.
Our results indicate that the triamcinolone acetonide component responsible for the patient's reaction was the suspending agent carboxymethylcellulose. We urge physicians to consider component testing when patients experience allergic-type reactions to drugs.
对各种皮质类固醇的过敏反应很少见，但此前已有报道。
我们希望确定一名接受皮内注射康宁克通（曲安奈德）的患者发生过敏反应的病因。
对患者及其他六名非过敏者进行了针对曲安奈德及其各成分以及其他三种皮质类固醇制剂的皮肤试验和过敏原特异性IgE抗体的血清学检测。
该患者仅对曲安奈德的羧甲基纤维素成分皮肤试验呈阳性。他对其他三种不含羧甲基纤维素的类固醇制剂皮肤试验反应阴性。通过免疫测定和免疫印迹法检测，针对羧甲基纤维素的特异性IgE抗体也升高。对照患者对曲安奈德及其成分以及其他三种皮质类固醇制剂皮肤试验均为阴性，且他们的血清中缺乏针对这些物质的显著特异性IgE抗体。
我们的结果表明，导致该患者反应的曲安奈德成分是悬浮剂羧甲基纤维素。我们敦促医生在患者对药物出现过敏样反应时考虑进行成分检测。
