title: Allergic reaction to epinephrine preparation in 2% lidocaine: two case reports.
abstract: We report 2 cases of hypersensitivity to an epinephrine preparation in local anesthetics which were found by skin tests for local anesthetics. Both patients had uncomfortable episodes to local anesthetics at dental treatment. In both cases, the skin tests showed positive reactions to 2% lidocaine with 1:80,000 epinephrine. Furthermore drug lymphocyte stimulation test revealed positive reaction to epinephrine hydrochloride, epinephrine bitartrate in case 1, whereas in case 2, the drug lymphocyte stimulation test showed positive response to epinephrine bitartrate. Attention should be paid to exogenous epinephrine preparations that have the potential to induce hypersensitivity during dental treatment.
authors.affiliation: Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. hkohase.anph@tmd.ac.jp
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kohase
authors.forename: Masahiro
authors.initials: M
authors.lastname: Umino
mesh_terms: D000293:Adolescent; D000779:Anesthetics, Local / Q000008:administration & dosage; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D004342:Drug Hypersensitivity; D004487:Edema / Q000139:chemically induced; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000209:etiology; D012882:Skin Tests
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D004837:Epinephrine