IntroductionImmediate hypersensitivity to glucocorticoids is rarelyreported, especially in children. Assessment of crossreactivityafter immediate hypersensitivity to intravenousmethylprednisolone (MP) usually shows a tolerance to atleast one of the alternatives, e.g. MP tablet, hydrocortisone(HC) or dexamethasone (DX).MethodsWe present 8 children with suspected hypersensitivityreaction after parenteral MP (6 children), DX inhalation(1 child) and inhafluticasone propionate (FL) (1 child).Prick and intradermal skin testing with MP, HC, DX andFL were performed. In case of negative skin tests provocationtests were performed. Basophil activation test (flowcytometry analyses of basophil CD63 surface expressioninduced by different concentrations of MP, HC, DX andFL (333, 33,3 and 3,33 mcg/ml)) was performed in allpatients and in ten controls who tolerated those drugs.Stimulation index (SI) >2 was considered positive.ResultsAll children (5 boys, 3 girls) were atopics and wereexposed to various glucocorticoids before systemichypersensitivity reaction. In 7 children allergy to culpritglucocorticoid was confirmed. 6 children had positiveresults of either skin testis or provocation test withthree or four glucocorticoids and 2 children to MP only.Four children had also positive results of either skintesting or provocation test to FL. In three children positiveprovocation test after negative skin test confirmedallergy to glucocorticoid. BAT was positive in 6 children:5 MP, 3 HC, 5 DX, 3 FL. One child with positive skintest to MP had negative BAT. One child was BAT nonresponder.One child who tolerated FL had positiveBAT to FL. BAT to MP, DX, HC was negative in all tencontrols (SI<1). However, BAT with nasal drops of FLwas positive in 3 controls (2展开▼
