An anaphylactic reaction to transdermal delivered fentanyl.
Immediate allergic hypersensitivity reactions with fentanyl are rarely reported. We diagnosed a presumably IgE-mediated allergic hypersensitivity reaction comprising generalized erythema and bronchospasm 4 h after the first-time application of transdermal fentanyl. Prick test remained negative with fentanyl whereas an intradermal test (IDT) with fentanyl was positive (dilution 10(-2)). Cross-reactivity was found with sufentanil but not with remifentanil. The diagnosis was supported by the clinical history and a positive IDT with fentanyl. This case report confirms the need for a systematic allergological investigation in case of immediate hypersensitivity reactions for all drugs and all modes of administration.
Dewachter
P
P
Service d'Anesthésie-Réanimation Chirurgicale & SAMU de Paris, Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes, Paris, France. pascale.dewachter@yahoo.fr
Lefebvre
D
D
Kalaboka
S
S
Bloch-Morot
E
E
D000279:Administration, Cutaneous; D000420:Albuterol / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000707:Anaphylaxis / Q000188:drug therapy / Q000209:etiology*; D050110:Bariatric Surgery; D001986:Bronchial Spasm / Q000188:drug therapy / Q000209:etiology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000188:drug therapy; D004890:Erythema / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008875:Middle Aged; D012882:Skin Tests
D000701:Analgesics, Opioid; D001993:Bronchodilator Agents; D007073:Immunoglobulin E; D000420:Albuterol; D005283:Fentanyl