Hypersensitivity to glucocorticoids: does it exist?
Hypersensitivity to corticosteroids is a classical but rarely reported event. We report a 30-year-old patient who developed generalized urticaria after her first methylprednisolone bolus. We reviewed the relevant literature to look for factors associated with hypersensitivity to corticosteroids. Causality should be evaluated on a case-by-case basis using diagnostic criteria for drug hypersensitivity reaction. Etiopathogenesis may involve either an IgE-mediated immunoallergic reaction or semi-delayed hypersensitivity. The main problems are identification of the offending agent and evaluation of the safety of further corticosteroid therapy. Although a few fatal reactions have been reported, some were probably due to underlying cardiovascular disease or serum electrolyte abnormalities.
Pizzuti
P
P
Rheumatology Department (Viggo Petersen Center), Lariboisière Teaching Hospital, Paris, France.
Lioté
F
F
Cerf-Payrastre
I
I
Dryll
A
A
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003875:Drug Eruptions / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D004342:Drug Hypersensitivity; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D005938:Glucocorticoids; D008775:Methylprednisolone