Multiple corticosteroids allergy in a patient with asthma: a case report

Background: Allergy towards systemic corticosteroid is rare. This case report discusses the investigations to confirm diagnosis and alternative treatments. Case presentation: A 51-year-old asthmatic woman developed severe anaphylactic reaction following administration of systemic hydrocortisone. Ski...

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Main Authors: Mahadi, Mahrunissa, Wan Ahmad Kammal, Wan Syazween Lyana, Md Nor, Norazirah, Jamil, Adawiyah
Format: Article
Language:English
Published: Springer 2020
Online Access:http://psasir.upm.edu.my/id/eprint/86858/
http://psasir.upm.edu.my/id/eprint/86858/1/Modification%20of%20cellulose%20degree%20of%20polymerization%20%281%29.pdf
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author Mahadi, Mahrunissa
Wan Ahmad Kammal, Wan Syazween Lyana
Md Nor, Norazirah
Jamil, Adawiyah
author_facet Mahadi, Mahrunissa
Wan Ahmad Kammal, Wan Syazween Lyana
Md Nor, Norazirah
Jamil, Adawiyah
author_sort Mahadi, Mahrunissa
building UPM Institutional Repository
collection Online Access
description Background: Allergy towards systemic corticosteroid is rare. This case report discusses the investigations to confirm diagnosis and alternative treatments. Case presentation: A 51-year-old asthmatic woman developed severe anaphylactic reaction following administration of systemic hydrocortisone. Skin prick, intradermal, and intravenous provocation tests confirmed allergy to triamcinolone, hydrocortisone, and dexamethasone. Skin prick tests (SPTs) were negative to all the aforementioned drugs. Intradermal test (IDT) with triamcinolone 1:10 concentration resulted in a 2-mm wheal associated with rhonchi. IDT with hydrocortisone 1:10 concentration showed an 8-mm wheal with rhonchi. IDTs to dexamethasone and carboxymethylcellulose were negative. Generalized rhonchi were observed with intravenous dexamethasone full concentration challenge. Conclusions: Corticosteroid allergy should be suspected in asthma patients with worsening bronchospasm after its administration. Due to its rarity, such diagnosis can easily be missed, resulting in increased morbidity and mortality in patients.
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spelling upm-868582021-11-22T02:37:47Z http://psasir.upm.edu.my/id/eprint/86858/ Multiple corticosteroids allergy in a patient with asthma: a case report Mahadi, Mahrunissa Wan Ahmad Kammal, Wan Syazween Lyana Md Nor, Norazirah Jamil, Adawiyah Background: Allergy towards systemic corticosteroid is rare. This case report discusses the investigations to confirm diagnosis and alternative treatments. Case presentation: A 51-year-old asthmatic woman developed severe anaphylactic reaction following administration of systemic hydrocortisone. Skin prick, intradermal, and intravenous provocation tests confirmed allergy to triamcinolone, hydrocortisone, and dexamethasone. Skin prick tests (SPTs) were negative to all the aforementioned drugs. Intradermal test (IDT) with triamcinolone 1:10 concentration resulted in a 2-mm wheal associated with rhonchi. IDT with hydrocortisone 1:10 concentration showed an 8-mm wheal with rhonchi. IDTs to dexamethasone and carboxymethylcellulose were negative. Generalized rhonchi were observed with intravenous dexamethasone full concentration challenge. Conclusions: Corticosteroid allergy should be suspected in asthma patients with worsening bronchospasm after its administration. Due to its rarity, such diagnosis can easily be missed, resulting in increased morbidity and mortality in patients. Springer 2020-08-25 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/86858/1/Modification%20of%20cellulose%20degree%20of%20polymerization%20%281%29.pdf Mahadi, Mahrunissa and Wan Ahmad Kammal, Wan Syazween Lyana and Md Nor, Norazirah and Jamil, Adawiyah (2020) Multiple corticosteroids allergy in a patient with asthma: a case report. The Egyptian Journal of Internal Medicine, 32. art. no. 4. pp. 1-3. ISSN 1110-7782; ESSN: 2090-9098 https://ejim.springeropen.com/articles/10.1186/s43162-020-00008-x 10.1186/s43162-020-00008-x
spellingShingle Mahadi, Mahrunissa
Wan Ahmad Kammal, Wan Syazween Lyana
Md Nor, Norazirah
Jamil, Adawiyah
Multiple corticosteroids allergy in a patient with asthma: a case report
title Multiple corticosteroids allergy in a patient with asthma: a case report
title_full Multiple corticosteroids allergy in a patient with asthma: a case report
title_fullStr Multiple corticosteroids allergy in a patient with asthma: a case report
title_full_unstemmed Multiple corticosteroids allergy in a patient with asthma: a case report
title_short Multiple corticosteroids allergy in a patient with asthma: a case report
title_sort multiple corticosteroids allergy in a patient with asthma: a case report
url http://psasir.upm.edu.my/id/eprint/86858/
http://psasir.upm.edu.my/id/eprint/86858/
http://psasir.upm.edu.my/id/eprint/86858/
http://psasir.upm.edu.my/id/eprint/86858/1/Modification%20of%20cellulose%20degree%20of%20polymerization%20%281%29.pdf