Allergy workup in immediate-type local reactions to glatiramer acetate.
Local reactions to glatiramer acetate are common, but few cases of hypersensitivity reaction have been reported. We present 3 patients with multiple sclerosis who suffered immediate-type local reactions after subcutaneous injection of glatiramer acetate. Skin prick test (SPT), intradermal test (IDT), and determination of immunoglobulin (Ig) E to glatiramer acetate were performed in patients and controls (enzyme-linked immunosorbent assay). The results of SPT were all negative. Those of IDT in controls were negative at concentrations below 200 microg/mL, but positive for patients 1, 2, and 3 at 2, 20, and 200 microg/mL, respectively. Serum IgE to glatiramer acetate in patient 1 was 2.1 times higher than in the controls, whereas no differences were found between controls and patients 2 and 3. Glatiramer acetate was safely reintroduced in patients 2 and 3. The results obtained for patient 1 suggest that an IgE-mediated mechanism was probably involved. In conclusion, IDT and serum IgE determination to glatiramer acetate seem useful for identifying allergic reactions among the common local reactions induced by this drug.
Department of Allergy, Hospital Clinico San Carlos, Madrid, Spain.
J
J
Sánchez-López
P
P
Rodríguez del Rio
B
B
Cases-Ortega
C
C
Martínez-Cócera
M
M
Fernández-Rivas
D000328:Adult; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis*; D007073:Immunoglobulin E / Q000097:blood; D007279:Injections, Subcutaneous; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D010455:Peptides / Q000009:adverse effects* / Q000276:immunology; D012882:Skin Tests
D010455:Peptides; D007073:Immunoglobulin E; D000068717:Glatiramer Acetate