Hydrocortisone sensitivity: Clinical features of fifty-nine cases

Wilkinson, S. M.; English, John

doi:10.1016/0190-9622(92)70237-a

Cited by 53 publications

(29 citation statements)

References 19 publications

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“…This could explain the association observed between ACD to topical GCs and stasis dermatitis, leg ulcers and dermatitis in the perineal area [12,13], even though, in general, all chronic dermatitis, such as hand dishydrosis, genital lichen simplex, seborrheic facial dermatitis, and atopic and contact eczema certainly are risk factors for an allergic contact sensitization to GCs [14]. In fact, it is thought that sensitization occurs in these cases because of an impaired barrier function of the skin [6,15].…”

Section: Nonimmediate Reactionsmentioning

confidence: 88%

Cross-Reactivity in Cell-Mediated and IgE-Mediated Hypersensitivity to Glucocorticoids

Ventura

Calogiuri²,

Muratore³

et al. 2006

CPD

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In the last few decades, glucocorticoids have received increasing attention for their capability of provoking systemic hypersensitivity reactions, when administered orally, parenterally, or intralesionally, as well as allergic skin and mucosal symptoms, when applied locally to the skin in patients with contact dermatitis or to the mucosa in patients with asthma and/or rhinitis. However, because of their anti-inflammatory and immunosuppressive properties, glucocorticoids are often not suspected of such hypersensitivity reactions. In addition, because glucocorticoids retain their anti-inflammatory potential, even if they act as sensitizers, the signs and symptoms of allergic reactions are not always obvious, particularly when they overlap with those caused by the very diseases glucocorticoids are used to treat. Moreover, interpretation of diagnostic tests, specifically that of patch-test reactions, can be difficult. In this review, particular attention is addressed to the problem of allergenic cross-reactivity among topical and systemic glucocorticoids. We also look at the clinical and practical aspects of both cell-mediated and IgE-mediated hypersensitivity reactions to glucocorticoids and their consequences on anti-inflammatory therapeutic choices.

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Section: Nonimmediate Reactionsmentioning

confidence: 88%

Cross-Reactivity in Cell-Mediated and IgE-Mediated Hypersensitivity to Glucocorticoids

Ventura

Calogiuri²,

Muratore³

et al. 2006

CPD

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“…55,56 The low molecular weight of corticosteroid molecules should prevent it from becoming immunogenic but the degradation of the C17 side chain allows it to bind to amino acids to generate a haptenprotein complex, which can act as an allergen. 55,56 The low molecular weight of corticosteroid molecules should prevent it from becoming immunogenic but the degradation of the C17 side chain allows it to bind to amino acids to generate a haptenprotein complex, which can act as an allergen.…”

Section: Allergic Contact Dermatitis To Tcsmentioning

confidence: 99%

Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement

et al. 2015

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Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.

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“…Hypersensitivitätsreaktionen können entweder als IgE-vermittelte Sofortreaktion (Typ I nach Coombs and Gell) auftreten [2,5,10],wie sehr wahrscheinlich im geschilderten Fall, oder häufiger als verzögerte Reaktion (Typ IV) [3,13,24,25]. Ein Teil der Reaktionen ist möglicherweise nicht allergisch bedingt [5,8,11].…”

Section: Pathogeneseunclassified

Anaphylaktischer Schock nach intravenöser Hydrokortisonsuccinatgabe

2002

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Glucocorticoids are frequently used in clinical anaesthesiology and intensive care because of their antiallergic, antiinflammatory and antioedematous properties and anaphylactic reactions are rare. We report on a 62-year-old asthmatic patient with evidence of aspirin sensitivity. We administered 100 mg of hydrocortisone-21-hemisuccinate (Pharmacia & Upjohn, Erlangen, Germany) dissolved in 100 ml 0.9% sodium chloride solution for perioperative corticoid substitution. The patient immediately developed severe bronchospasm and anaphylactic shock requiring intubation and mechanical ventilation. He received adrenaline, isoflurane, ketamine and inhalational fenoterol. He then developed atrioventricular block type III for which we transcutaneously paced the patient. Subsequently he was tested via skin prick tests, intracutaneous tests and i.v.-challenges resulting in the patient having positive reactions to hydrocortisone-21-hemisuccinate. Thus when allergic-like reactions result from glucocorticoid therapy one should consider corticoid allergy as a differential diagnosis.

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Hydrocortisone sensitivity: Clinical features of fifty-nine cases

Cited by 53 publications

References 19 publications

Cross-Reactivity in Cell-Mediated and IgE-Mediated Hypersensitivity to Glucocorticoids

Cross-Reactivity in Cell-Mediated and IgE-Mediated Hypersensitivity to Glucocorticoids

Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement

Anaphylaktischer Schock nach intravenöser Hydrokortisonsuccinatgabe

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