Anaphylaxis to oral iron salts. desensitization protocol for tolerance induction.
Allergies to iron salts are seldom reported. We studied a patient with iron-deficiency anemia who had suffered anaphylactic reactions caused by oral iron salts. An allergy study was performed using single-blind, placebo-controlled oral challenge and skin tests with various iron salts as well as excipients in commercial formulations. Oral challenges were positive for 2 of the commercial formulations of iron salts. Intradermal tests with ferrous sulphate and ferrous lactate also showed positive results. All of the cutaneous tests using the excipients were negative. A desensitization protocol was designed which enabled us to readminister ferrous sulphate, although antihistamines were necessary to guarantee good tolerance to iron salts. We report a patient with allergy to iron salts, positive skin tests, and positive controlled challenge. We highlight the desensitization protocol designed to complete the therapeutic management of the anemia.
de Barrio
M
M
Allergy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. mdebarriof@hotmail.com
Fuentes
V
V
Tornero
P
P
Sánchez
I
I
Zubeldia
J
J
Herrero
T
T
D000368:Aged; D000707:Anaphylaxis / Q000276:immunology / Q000628:therapy*; D002090:Butyrophenones / Q000627:therapeutic use; D002744:Chlorpheniramine / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000628:therapy*; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D007773:Lactates / Q000008:administration & dosage / Q000009:adverse effects*; D010880:Piperidines / Q000627:therapeutic use
D002090:Butyrophenones; D005296:Ferrous Compounds; D006634:Histamine H1 Antagonists; D007773:Lactates; D010880:Piperidines; C020748:ferrous sulfate; C018904:dexchlorpheniramine; D002744:Chlorpheniramine; C101012:ferrous lactate; C058249:ebastine