title: [Measles-Mumps-Rubella vaccination of an egg-allergic child sensitized to gelatin].
abstract: The Measles-Mumps-Rubella (MMR) vaccine is often postponed in egg-allergic patients due to fear of anaphylactic reaction at the time of injection of this vaccin produced on egg derivates. However, this vaccine is recommended by health authorities, especially in case of increased measles incidence, and international recommendations indicate that there is no need for predictive allergological work-up and that the MMR vaccine is well tolerated in egg-allergic patients. We report on the case of a 12-year-old child with severe immediate-type egg allergy. Immediate-reading intradermal skin tests performed prior to the MMR vaccine were positive. Subsequent allergological work-up revealed a gelatin sensitization, and the child tolerated injections of the vaccine given according to a tolerance induction protocol. Gelatin is used as a stabilizer in numerous vaccines and may be responsible for immediate-type hypersentivity reactions to gelatin-containing vaccines. In case of reaction induced by the MMR vaccine, one needs to explore a potential gelatin sensitization/allergy. The MMR vaccine should be given and is well tolerated in patients with immediate-type egg hypersensitivity, even when gelatin sensitization is combined.
authors.affiliation: Service de pédiatrie, hôpitaux du Léman, site Georges-Pianta, 3, avenue de la Dame, 74203 Thonon-Les-Bains, France. b-dumortier@ch-hopitauxduleman.fr
authors.forename: B
authors.initials: B
authors.lastname: Dumortier
authors.forename: A
authors.initials: A
authors.lastname: Nosbaum
authors.forename: C
authors.initials: C
authors.lastname: Ponvert
authors.forename: J-F
authors.initials: JF
authors.lastname: Nicolas
authors.forename: F
authors.initials: F
authors.lastname: Bérard
mesh_terms: D002648:Child; D021181:Egg Hypersensitivity / Q000150:complications; D005780:Gelatin / Q000009:adverse effects*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications*; D007115:Immunization Schedule; D007073:Immunoglobulin E / Q000032:analysis; D007267:Injections; D007428:Intradermal Tests; D017336:Loratadine / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D011292:Premedication; D013997:Time Factors; D014611:Vaccination
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating; D022542:Measles-Mumps-Rubella Vaccine; D007073:Immunoglobulin E; D017336:Loratadine; D005780:Gelatin; C121345:desloratadine