Anaphylactic shock after intra-articular injection of carboxymethylcellulose.
BACKGROUND
Sodium carboxymethylcellulose (SCMC) is the sodium salt of a polycarboxymethyl ether of cellulose. SCMC is widely used in pharmaceutical and food industries. We present the case of a 47-year-old man who suffered an anaphylactic shock after an intra-articular injection of Trigon depot.


RESULTS
Prick and intradermal tests with Trigon depot and its components (triamcinolone acetonide, Tween 80, benzylalcohol, SCMC), mepivacaine 2% and latex were performed. Challenge test with mepivacaine 2% was also realized.


RESULTS
Showed a positive intradermal test to Trigon depot and carboxymethylcellulose, with negative results to the rest (including challenge test to mepivcaine 2%).


CONCLUSIONS
Our results support the diagnosis of anaphylactic shock after intra-articular injection of carboxymethylcellulose and we consider necessary to emphasize that excipients must be taken into account as a potential source of adverse reactions to drugs.
Montoro
J
J
Al-lergo Centre, Barcelona, Spain. jmontorol@meditex.es
Valero
A
A
Elices
A
A
Rubira
N
N
Serra-Baldrich
E
E
Amat
P
P
Malet
A
A
D000707:Anaphylaxis / Q000209:etiology*; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage / Q000009:adverse effects*; D005079:Excipients / Q000009:adverse effects; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D012882:Skin Tests
D005079:Excipients; D002266:Carboxymethylcellulose Sodium