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首页> 外文期刊>Clinical and Translational Allergy >Anaphylaxis due to I.V. prednisolone application in two patients suffering from multiple sclerosis
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Anaphylaxis due to I.V. prednisolone application in two patients suffering from multiple sclerosis

机译：因静脉感染而引起的过敏反应泼尼松龙在两名多发性硬化症患者中的应用

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BackgroundJust a few weeks apart, two women in their forties werepresented by neurologists at our outpatient clinic. Bothsuffered from multiple sclerosis (MS) and were alwayssuccessfully treated with i.v. prednisolone when in acuterelapse. Both patients developed at the last treatmentwith prednisolone generalized urticara, dyspnea andhypotension. They were then treated and stabilized withantihistamines and volume expanders.MethodsSkin-Prick (SPT) and intradermal (i.d.) tests were performedwith prednisolone as the probable causative agentand as alternatives with methylprednisolone, triamcinoloneand dexamethasone. Additionally, drug provocationtests (DPT) with alternatives and / or SPT negative preparationswere performed intravenously.ResultsAll prick tests resulted in both patients negative. In onepatient, only i.d. test with prednisolone turned positive,all other steroids were negative and she tolerated i.v.application of negative tested steroids. In the otherpatient, the i.d. test with prednisolone and methylprednisolonewere positive and she tolerated DPT with triamcinolonewell.ConclusionsCorticosteroid preparations are used to treat allergic reactionsand anaphylaxis but in patients who are often treatedwith systemic steroids, as it was the case in both of ourpatients with MS, allergic sensitization to steroids candevelop. Therefore, allergologic work-up is required for allsuspected corticosteroid immediate type reactions. Asmethylprednisolone may cross-react with prednisolone insome cases, in acute emergencies, it is recommended toswitch to triamcinolone or dexamethasone.
机译：背景资料相隔仅几周，我们门诊的神经科医生就代表了四十多岁的两名妇女。两者均患有多发性硬化症（MS），并始终接受i.v.治疗。泼尼松龙在急性复发时。两名患者在最后一次用泼尼松龙治疗后出现全身性荨麻疹，呼吸困难和低血压。然后用抗组胺药和扩容剂对其进行治疗和稳定。方法采用泼尼松龙作为可能的病因，并用甲基泼尼松龙，曲安西龙和地塞米松作为替代品，进行了皮刺试验和皮内试验。另外，静脉内进行了带有替代药物和/或SPT阴性制剂的药物激发试验（DPT）。结果所有的点刺试验均导致两名患者阴性。在一个患者中，只有i.d.泼尼松龙试验转为阳性，所有其他类固醇均为阴性，她耐受静脉内应用阴性的类固醇。在另一位患者中结论泼尼松龙和甲基泼尼松龙试验呈阳性，曲安奈德耐受DPT。因此，所有怀疑的皮质类固醇立即型反应都需要进行过敏学检查。在某些情况下，甲基泼尼松龙可能会与泼尼松龙发生交叉反应，在紧急情况下，建议改用曲安西龙或地塞米松。

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