title: Anaphylaxis to calcitonin.
abstract: BACKGROUND
  The calcitonin is an hormone produced by the thyroid gland C cells. The salmon calcitonin is used in some osteomuscular diseases. There are few references of allergic reaction to this hormone. We introduce a case of a sixty years old woman with several previous episodes of rhinitis, conjunctivitis and perspiration immediately after the administration of salmon calcitonin with nasal spray or intramuscular administration (Calsynar). There were some temporal periods of good tolerance between these episodes.
  
  
  METHODS
  Skin prick test (SPT), nasal and intramuscular challenge test with commercial salmon calcitonin (Miacalcic) were performed. Leukocyte histamine release test with salmon calcitonin and serum tryptase levels at baseline and after intramuscular challenge test were performed.
  
  
  RESULTS
  The patient skin prick test with commercial calcitonin (Miacalcic. 50 UI/ml) was positive and negative in controls. The nasal challenge test with a calcitonin nasal spray, up to 150 UI, was negative. The intramuscular challenge test with 25 UI of Miacalcic was positive with an immediate anaphylactic reaction. Whole blood histamine release studies were negative. Serum tryptase levels after intramuscular challenge did not increase significantly with regard to the basal levels.
  
  
  CONCLUSIONS
  We have introduced a case of anaphylaxis by calcitonin that suggest an IgE mediated hypersensitivity reaction.
authors.affiliation: Department of Allergy, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: S L
authors.initials: SL
authors.lastname: Porcel
authors.forename: J A
authors.initials: JA
authors.lastname: Cumplido
authors.forename: B
authors.initials: B
authors.lastname: de la Hoz
authors.forename: M
authors.initials: M
authors.lastname: Cuevas
authors.forename: E
authors.initials: E
authors.lastname: Losada
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D002116:Calcitonin / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006636:Histamine Release; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007273:Injections, Intramuscular; D008875:Middle Aged; D009299:Nasal Provocation Tests; D010024:Osteoporosis / Q000188:drug therapy; D012697:Serine Endopeptidases / Q000097:blood; D012882:Skin Tests; D053802:Tryptases
chemical_list: D007073:Immunoglobulin E; C028815:salmon calcitonin; D002116:Calcitonin; D012697:Serine Endopeptidases; D053802:Tryptases