Delayed hypersensitivity reactions to corticosteroids.
BACKGROUND
Corticosteroids (CS) are widely used in the treatment of asthma, allergic disorders and other immunological diseases due to their anti-inflammatory and immunosuppressive properties. Physicians seldom suspect them of causing allergic reactions. However, more and more cases of hypersensitivity reactions to CS have been described. Reports of delayed allergic reactions to CS in patients with asthma or allergic rhinitis are scarce.


METHODS
We report the case of a 44-year-old woman with a history of mild persistent asthma and intermittent allergic rhinitis, treated with inhaled beclomethasone and salbutamol, who developed a delayed mucocutaneous and respiratory reaction after substitution of beclomethasone with budesonide.


CONCLUSIONS
The interest of this case lies in the rarity of allergic reactions from inhaled CS in patients with asthma and/or rhinitis. These reactions therefore represent a diagnostic and therapeutic challenge.
Cadinha
S
S
Serviço de Imunoalergologia, Hospital São João, Porto, Portugal. scadinha@clix.pt
Malheiro
D
D
Rodrigues
J
J
Castro
E
E
Castel-Branco
M G
MG
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003429:Cross Reactions; D003875:Drug Eruptions / Q000209:etiology; D004342:Drug Hypersensitivity / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D010328:Patch Tests; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000188:drug therapy; D012882:Skin Tests
D000305:Adrenal Cortex Hormones; D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D019819:Budesonide; D001507:Beclomethasone; D000420:Albuterol