Immediate allergic reactions by polyethylene glycol 4000: two cases.

The evacuant solution (ES) is a drug that has been used to clean the colon. The most common described side effects when using this drug are abdominal symptoms; skin rash is rare. We report on two patients who presented urticaria and angioedem after the intake of an evacuant solution to make a rectoscopy. We performed allergy studies: skin prick tests with common inhalants, pure ES and the components (polyethylene glycol 4000 (PEG 4000), KCI, NaCO3, NaPO3, NaSO3, NaCI, neohesperydine, potasic acesulfam and orange flavouring), intradermic test, total serum IgE and single-blind placebo oral challenge with ES and the components. We report on the first cases of immediate allergy reactions (type1) caused by oral intake of a drug containing PEG 4000 which were demonstrated by intradermic tests and oral challenge.

Immediate allergic reactions by polyethylene glycol 4000: two cases

The evacuant solution (ES) is a drug that has been used to clean the colon. The most common described side effects when using this drug are abdominal symptoms; skin rash is rare. We report on two patients who presented urticaria and angioedem after the intake of an evacuant solution to make a rectoscopy. We performed allergy studies: skin prick tests with common inhalants, pure ES and the components (polyethylene glycol 4000 (PEG 4000), KCI, NaCO3, NaPO3, NaSO3, NaCI, neohesperydine, potasic acesulfam and orange flavouring), intradermic test, total serum IgE and single-blind placebo oral challenge with ES and the components. We report on the first cases of immediate allergy reactions (type1) caused by oral intake of a drug containing PEG 4000 which were demonstrated by intradermic tests and oral challenge

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Urticaria induced by antihistamines.

H1-antihistamines are commonly used drugs, and probably the most frequently used for allergic diseases. They are pharmacologic inverse agonists of histamine at H1 receptor sites and try to shift the equilibrium of this receptor toward the inactive state, preventing H1 response. A wide variety of adverse effects have been attributed to antihistamines, and they can exceptionally induce skin reactions. We report the case of a patient with several episodes of urticaria induced by different families of antihistamines - piperazines and piperidines. We performed skin prick tests (SPT), patch tests and oral challenges to different antihistamines. We found positive SPT to some antihistamines, and positive oral challenge in others with negative SPT. The route of sensitization remained unclear, and our patient could not finally tolerate any antihistamine after the oral challenges we performed. We support the hypothesis that antihistamines may shift the H1 histamine receptor to the active conformation instead of the inactive conformation, prompting adverse reactions after dosing. This is the first report of urticaria induced by different antihistamines in the same patient with positive SPT to several others.

Tacrolimus como tratamiento de la dermatitis atópica: estudio piloto observacional en la práctica clínica / Tacrolimus, a new treatment to atopic dermatitis: an observational pilot study in routine clinical practice

Antecedentes: Los antinflamatorios no esteroideos (AINE) como el ácido acetilsalicílico, diclofenaco o las pirazolonas se encuentran entre las causas más comunes de reacciones adversas a los fármacos. Durante los últimos años han surgido nuevos antiinflamatorios con una acción selectiva preferente por la vía dela cicloxigenasa 2. Se han realizado multitud de ensayos clínicos. Especialmente con nimesulida que se ha retirado del mercado y rofecoxib que indican que son bien tolerados por los pacientes intolerantes a Al E. Pero se han realizado pocos en ayos clínicos sobre la tolerancia a meloxicam. Material y métodos: Hemos seleccionado 20 pacientes con una anamnesis urgente de intolerancia a diversos AI E y. tras obtener su consentimiento informado, les hemos expuesto a dosis cada vez mayores de meloxicam hasta alcanzar una dosis acumulada de 22,5 mg. en la misma sesión. Resultados: Los veinte pacientes han tolerado meloxicam sin problemas. Conclusiones: En los pacientes estudiados meloxicam parece ser una alternativa terapéutica eficaz y segura al resto de los Al E. Creemos necesario realizar estudios más amplios con grupos grandes de pacientes sano intolerantes a Al E. asmáticos con intolerancia a AINES y pacientes con urticaria crónica que no toleran los antinflamatorios para confirmarlo (AU)

Background: Nonsteroidal antiinflamatories ( SAIDs), such as acetyl salicylic acid, diclofenac. metamizol are one of the most common cause of adverse reactions to drugs. Last years, new elective ciclooxigenase Il antiinflamatories have appeared. Several clinic a say have been performed, fir t with nimesulide, actually retired, and larger with rofecoxib, that indicate good tolerance to them in intolerance patients to NSAJDs. There are few studies with meloxicam. Methods: We have included 20 patient with clinical hi tory of intolerance to at least two different NSAIDs. After obtained their informed consent patients (…) (AU)