Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/clasificación , Rotura/etiología , Anciano , Anciano de 80 o más Años , Remoción de Dispositivos , Femenino , Tracto Gastrointestinal/lesiones , Humanos , Masculino , Persona de Mediana Edad , Rotura/terapia , Stents Metálicos AutoexpandiblesRESUMEN
BACKGROUND: Carboxymethylcellulose is a high-molecular-weight polysaccharide molecule used as a binding agent, for coating molecules and to increase the viscosity of formulations. It is present in a large number of pharmaceutical products but is also found in food and cosmetics. CASE-REPORT: We report two cases of patients who presented anaphylactic reactions immediately after localised corticosteroid injections; intra-articular for the first and intralesional for the second. Allergological testing for different corticosteroids and carboxymethylcellulose by means of prick-tests and intradermal testing indicated that the immediate hypersensitivity reaction was caused by the excipient, carboxymethylcellulose. The excellent safety of oral reintroduction of carboxymethylcellulose in a pharmaceutical preparation in these two patients confirmed that this large molecule is not absorbed through the digestive system. DISCUSSION: The avoidance list of products containing carboxymethylcellulose could be greatly reduced and limited to only injectable pharmaceutical preparations containing carboxymethylcellulose and to oral contrast media containing large quantities of carboxymethylcellulose.