title: Anaphylactic shock caused by impurities in orgotein preparations.
abstract: Previously reported allergic reactions to orgotein (superoxide dismutase) injections has assigned responsibility to this molecule, which is obtained from bovine liver. We report an anaphylactic shock probably caused by impurities contained in an orgotein preparation. Prick test to Peroxinorm (orgotein), BSA, and cow liver extract were positive but resulted negative with chymotrypsin, milk, meat and cow epithelium extracts. Tryptase levels determined 3, 24 hours and 15 days after the shock measured 6.32, 0.81 and 0.84 U/L respectively. Detection of specific IgE to Peroxinorm, BSA and chymotrypsin by ELISA was negative and positive to cow liver. Specific IgE to milk and cow epithelium by Pharmacia CAP system was negative. Immunoblotting with Peroxinorm revealed IgE specific bands at an apparent M.W of 67, 51, 56 and 16 kDa; immunoblotting with cow liver revealed bands at 72, 56, 50 and 36 kDa; immunoblotting with BSA and chymotypsin were negative. This case emphasises the role that 20 % of impurities of the pharmaceutical preparation may have in immediate hypersensitivity reactions.
authors.affiliation: Sección de Alergia, Hospital General Universitario Gregorio Marañón, Madrid, Spain. vbenitor@meditex.es
authors.forename: V
authors.initials: V
authors.lastname: de Benito
authors.forename: M
authors.initials: M
authors.lastname: de Barrio
authors.forename: M P
authors.initials: MP
authors.lastname: de López-Sáez
authors.forename: E
authors.initials: E
authors.lastname: Ordoqui
authors.forename: A
authors.initials: A
authors.lastname: Prieto-García
authors.forename: T
authors.initials: T
authors.lastname: Sainza
authors.forename: M L
authors.initials: ML
authors.lastname: Baeza
mesh_terms: D000485:Allergens / Q000009:adverse effects / Q000302:isolation & purification; D000707:Anaphylaxis / Q000209:etiology*; D000818:Animals; D002417:Cattle; D002918:Chymotrypsin / Q000276:immunology; D004340:Drug Contamination; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008099:Liver / Q000737:chemistry / Q000276:immunology; D008667:Metalloproteins / Q000009:adverse effects* / Q000737:chemistry; D008875:Middle Aged; D012697:Serine Endopeptidases / Q000097:blood; D012710:Serum Albumin, Bovine / Q000276:immunology; D012882:Skin Tests; D053802:Tryptases
chemical_list: D000485:Allergens; D008667:Metalloproteins; D012710:Serum Albumin, Bovine; D007073:Immunoglobulin E; D012697:Serine Endopeptidases; D002918:Chymotrypsin; D053802:Tryptases; C005180:orgotein