Urticaria as a Rare Side Effect of Polyethylene Glycol-3350 in a Child: Case Report

Abstract

SUMMARY – Polyethylene glycol electrolyte (PEG-3350) solution is usually used for bowel emptying before colonoscopy in adults. It has also been reported to be safe in children. It is thought that bowel irrigation with this solution can be a useful treatment alternative for poisoning with slow releasing drugs, swallowed packaged substances, enteric coated drugs, drugs not binding to charcoal, and heavy metals in children. Due to high molecular weight of PEG-3350, its absorption from the intestinal mucosa is very low (0.2%). Therefore, it is less likely to have side effects. A three-year-old girl bit and ate one-third of an alkali battery and was brought to our pediatric emergency unit. Vital signs and results of physical examination and laboratory investigations were normal. Irrigation of the bowels with PEG-3350 solution given orally at a rate of 20 mL/kg/h was initiated. Upon excretion of feces of normal appearance in the sixth hour, irrigation was continued. Since rashes and itching started throughout her body in the thirtieth hour after administration of 9 L PEG-3350, the irrigation was discontinued and the patient was administered antihistamines. Rashes and itching regressed within one hour of its discontinuation. This suggested that they were due to the irrigation solution. There are five adult cases of allergic reactions to PEG-3350 reported in the literature. The case presented is the first pediatric patient developing allergic reaction to PEG-3350.

Cutaneous adverse events following 771 doses of the inactivated and mRNA COVID‐19 vaccines: A survey study among health care providers

“…The patient developed urticarial rash at the 30th hour after the administration of PEG‐3350. 15 Additionally, Cox et al 14 reported 6 cases who developed acute hypersensitivity to PEG‐containing products which were supported by the results of the applied skin prick tests. Furthermore, Sellaturay et al 16 demonstrated that allergy to PEG, may actually cause anaphylaxis to Pfizer/BioNTech vaccine by reporting a case of vaccine‐induced anaphylaxis in a patient who described a history of allergic reactions to multiple PEG‐containing products.…”

Lethal Complication From Inappropriately Prepared Polyethylene Glycol (Golytely) in a Pediatric Patient

“…Another rare complication of Golytely was reported in the case of a child who developed urticaria after undergoing bowel irrigation post-ingestion of an alkali battery. It resolved with the stopping of the irrigation and administration of anti-histamine [ 13 ]. This rare complication was also reported in an adult patient [ 14 ].…”

Probable neuropsychiatric toxicity of polyethylene glycol: roles of media, internet and the caregivers

“…There is sparse literature on side effects on PEG 3350. The reported side effects from these reports included: electrolyte abnormalities, abdominal pain, diarrhoea, nausea/vomiting, bloating/flatulence, and irritation of the anal area, bloating and gases or abdominal pain, allergy, raised ALT and one case with thirst, fatigue and nausea . One recent large study on clinical use of PEG reported one patient with headache as the only neurologic adverse effect while another fairly large randomised trial failed to document significant adverse reactions on long‐term maintenance therapy .…”