Simultaneous positive patch test reactions to neomycin and low-molecular-weight heparins: possible cross-reaction?

BACKGROUND: A patient received enoxaparin sodium subcutaneous injections for prophylaxis after surgery and developed inflammatory skin reactions on injection sites on Day 5 after the first administration. Patch test was performed with baseline series and low-molecular-weight heparins (LMWHs) at different concentrations and showed positive reactions to neomycin and LMWHs. Cross-reactivity between neomycin and LMWHs was suspected due to similar structure. OBJECTIVES: To establish the evidence of possible cross reaction between neomycin and LMWHs by patch testing. MATERIALS & METHODS: Patch testing of 12 individual controls with a history of neomycin contact allergy was performed. RESULTS: Positive patch test reactions to enoxaparin sodium, tinzaparin sodium, and neomycin sulphate were reported in the patients. None of the controls reacted to LMWHs. CONCLUSION: There was no proof of cross reaction between neomycin and LMWHs in this study, suggesting that the simultaneous reaction may be a coincidence. Since the number of individuals studied was low, allergy to LMWHs following injection in individuals with a history of neomycin allergy should be further investigated.

Comparison of data from the Norwegian Patient Register and the Cancer Registry of Norway.

BACKGROUND: The regulations of the Norwegian Patient Register (NPR) and the Cancer Registry of Norway (CRN) allow linkage of the registries for evaluation of completeness and validity of data. MATERIAL AND METHOD: Data on patients registered as having C18 (colon cancer), C19-C21 (cancer of the rectum, rectosigmoid junction or anus), C33-C34 (cancer of the lungs or trachea), C50 (breast cancer), C61 (prostate cancer) or C66-C68 (cancer of the bladder, ureter or urethra) were obtained from NPR 2008 and compared with data from CRN. RESULTS: 81 % of patients registered in NPR as having colon cancer were registered with the same diagnosis in CRN. Corresponding figures were 94 % for breast cancer (women), 97 % for prostate cancer, 82 % for cancer of the rectum, rectosigmoid junction or anus, 93 % for urinary tract cancer and 90 % for cancer of the lungs or trachea. In cases where NPR codes and CRN diagnoses did not match, a related diagnosis was often registered in the CRN. INTERPRETATION: The agreement between the data in NPR and CRN is relatively good for the diagnoses included in the study. The NPR codes are less precise for colon and rectal cancer than for the other major types of cancer. Regular exchange of data between the registries will further improve the quality of the data.