ABSTRACT
BACKGROUND: There has been little research into adverse reactions to proton pump inhibitors (omeprazole and its analogs) of suspected allergic etiology. We found nine studies in the medical literature and only two of these describe cross reactivity between proton pump inhibitors detected by skin prick tests. CASE REPORT: We present a 24-year-old woman who twice developed total body pruritus and urticaria with facial angioedema 1-2 hours after ingesting an omeprazole capsule. In the second episode the patient also reported the sensation of having a lump in her throat. METHODS: Skin prick and intradermal tests were performed with omeprazole, pantoprazole, and lansoprazole, which were positive for the three proton pump inhibitors. For ethical reasons, oral challenge testing was not performed. CONCLUSION: The clinical picture and the positive skin test results suggest an IgE-mediated mechanism. Skin prick tests may be useful for the diagnosis of cases of suspected allergy to omeprazole and its analogs. We found cross reactivity between three proton pump inhibitors detected by skin tests.
Subject(s)
Angioedema/etiology , Drug Eruptions/etiology , Enzyme Inhibitors/adverse effects , Omeprazole/analogs & derivatives , Omeprazole/adverse effects , Proton Pump Inhibitors , Pruritus/etiology , 2-Pyridinylmethylsulfinylbenzimidazoles , Adult , Benzimidazoles/immunology , Cross Reactions , Drug Eruptions/immunology , Enzyme Inhibitors/immunology , Female , Gastroesophageal Reflux/drug therapy , Humans , Immunoglobulin E/immunology , Intradermal Tests , Lansoprazole , Laryngeal Edema/etiology , Omeprazole/immunology , Pantoprazole , Skin Tests , Sulfoxides/immunologyABSTRACT
Antecedentes: Los casos descritos sobre reacciones adversas a los inhibidores de la bomba de protones (omeprazol y análogos) con sospecha de etiología alérgica son escasos, encontrando un total de nueve trabajos en la literatura médica. Únicamente en dos de ellos se ha descrito la existencia de reactividad cruzada entre varios miembros del grupo mediante pruebas cutáneas. Caso clínico: Se trata de una mujer de 24 años que presentó en dos ocasiones prurito y urticaria generalizados, con angioedema facial en un intervalo de 1-2 horas tras la toma de omeprazol por vía oral; en el segundo episodio refiere además sensación de cuerpo extraño en garganta. Métodos: Se realizan pruebas cutáneas por prick e intradermorreacción con omeprazol, lansoprazol y pantoprazol, con resultado positivo para los tres fármacos. No se realiza provocación oral por razones éticas. Conclusión: El desarrollo del cuadro clínico y la positividad de los tests cutáneos sugieren un mecanismo mediado por Ig E. Destaca la validez de las pruebas cutáneas en el diagnóstico de los casos de sospecha de alergia a omeprazol y análogos. Hemos encontrado la existencia de reactividad cruzada entre los inhibidores de la bomba de protones, mediante la positividad de pruebas cutáneas (AU)
Background: There has been little research into adverse reactions to proton pump inhibitors (omeprazole and its analogs) of suspected allergic etiology. We found nine studies in the medical literature and only two of these describe cross reactivity between proton pump inhibitors detected by skin prick tests. Case report: We present a 24-year-old woman who twice developed total body pruritus and urticaria with facial angioedema 1-2 hours after ingesting an omeprazole capsule. In the second episode the patient also reported the sensation of having a lump in her throat. Methods: Skin prick and intradermal tests were performed with omeprazole, pantoprazole, and lansoprazole, which were positive for the three proton pump inhibitors. For ethical reasons, oral challenge testing was not performed. Conclusion: The clinical picture and the positive skin test results suggest an IgE-mediated mechanism. Skin prick tests may be useful for the diagnosis of cases of suspected allergy to omeprazole and its analogs. We found cross reactivity between three proton pump inhibitors detected by skin tests (AU)
Subject(s)
Humans , Female , Adult , Drug Eruptions , Sulfoxides , Pruritus , Proton Pumps , Omeprazole , Laryngeal Edema , Immunoglobulin E , Angioedema , Cross Reactions , Benzimidazoles , Gastroesophageal Reflux , Enzyme Inhibitors , Skin Tests , Intradermal TestsABSTRACT
In this work, several immunological parameters were studied in a group of 40 patients diagnosed as having allergic rhinitis. As a control group we assembled 20 patients with cholinergic rhinitis. A significative increase in the level of serum IgM was detected in the patients with cholinergic rhinitis. The differences observed between other parameters (lymphocyte count, blastic transformation with PHA and Con-A), were not significative. We discuss the results.
