title: Immunoglobulin-mediated hypersensitivity in response to long-term treatment with gonadorelin hydrochloride (Factrel) in a female patient.
abstract: Recently a patient with severe hypogonadotropic hypogonadism who was given luteinizing hormone-releasing hormone (Factrel) through an infusion pump developed a wheat-and-flare reaction at the sites of injection. Treatment with luteinizing hormone-releasing hormone was discontinued and the immune response was characterized. Skin testing by skin prick test was positive for luteinizing hormone-releasing hormone but negative for vehicle. Radioallergosorbent testing was performed with allergic (patient serum with an elevated serum immunoglobulin E concentration and allergic to inhalant allergens including ragweed pollen) and nonallergic controls. Radioallergosorbent testing was negative for luteinizing hormone-releasing hormone-reactive immunoglobulin E antibodies. Radioimmunoassay of serum of the allergic patient antibody to luteinizing hormone-releasing hormone was positive only for immunoglobulin E. Maximum binding occurred at a dilution of 1:10. Sera from nonallergic and unchallenged patients were negative. It is concluded that this patient developed hypersensitivity reactions caused by IgE antibody to luteinizing hormone-releasing hormone.
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University Medical Centre, Hamilton, Ontario, Canada.
authors.forename: W G
authors.initials: WG
authors.lastname: Foster
authors.forename: J F
authors.initials: JF
authors.lastname: Jarrell
authors.forename: J
authors.initials: J
authors.lastname: Dolovich
authors.forename: E V
authors.initials: EV
authors.lastname: YoungLai
mesh_terms: D000328:Adult; D004342:Drug Hypersensitivity / Q000276:immunology*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D007136:Immunoglobulins / Q000009:adverse effects*; D007260:Infusion Pumps
chemical_list: D007136:Immunoglobulins; D007987:Gonadotropin-Releasing Hormone