Añíbarro B, Fontela J L
Allergy Unit, Hospital Virgen de la Luz, Cuenca, Spain.
Ann Allergy Asthma Immunol. 1997 Apr;78(4):345-6. doi: 10.1016/s1081-1206(10)63194-8.
To report a case of immediate rhinoconjunctivitis induced by both metamizole and metronidazole.
Skin-tests (prick and intradermal) were performed with metamizole, metronidazole, and espyramicine. Standard RAST was carried out with metamizole and metronidazole. Oral challenge tests were performed single blind with Rhodogil, metronidazole, espyramicine, metamizole, aspirin, and propyfenazone.
Both skin tests and RAST were negative. We also found that the patient tolerated therapeutic doses of espyramicine, aspirin, and propyfenazone. Challenges with Rhodogil, metamizole, and metronidazole elicited immediate rhinoconjunctivitis.
This is an exceptional case of immediate rhinoconjunctivitis induced by two unrelated drugs (metamizole and metronidazole). The pathogenic mechanism implicated in this process remains unclear. Inhibition of the cyclooxygenase pathway was excluded and we could not demonstrate the presence of specific IgE antibodies. Nevertheless, an immunologic or idiosyncratic mechanism could be responsible.
报告一例由安乃近和甲硝唑引发的速发型鼻结膜炎病例。
用安乃近、甲硝唑和乙磺半胱氨酸进行皮肤试验（点刺和皮内试验）。用安乃近和甲硝唑进行标准变应原特异性IgE检测（RAST）。用罗多吉、甲硝唑、乙磺半胱氨酸、安乃近、阿司匹林和丙氧芬那宗进行单盲口服激发试验。
皮肤试验和RAST均为阴性。我们还发现该患者能耐受治疗剂量的乙磺半胱氨酸、阿司匹林和丙氧芬那宗。用罗多吉、安乃近和甲硝唑激发会引发速发型鼻结膜炎。
这是一例由两种不相关药物（安乃近和甲硝唑）引起的速发型鼻结膜炎的特殊病例。该过程涉及的致病机制仍不清楚。排除了环氧化酶途径的抑制作用，且我们未能证明特异性IgE抗体的存在。然而，免疫或特异反应机制可能起作用。
