title: [Angioedema and paradoxical bronchoconstriction secondary to ipratropium bromide/salbutamol administered by metered dose inhaler in patients with soy allergy].
abstract: BACKGROUND
  There are some reports on the association between the use of ipratropium bromide/salbutamol and paradoxical bronchoconstriction and urticaria in patients with soy allergy.
  
  
  METHODS
  We describe four patients who displayed angioedema and paradoxical bronchoconstriction secondary to ipratropium bromide/salbutamol administered by metereddose-inhaler (MDI). In all of them soy allergy was demonstrated.
  
  
  RESULTS
  Four patients, two children and two adults, exhibited paradoxical bronchoconstriction and angioedema secondary to ipratropium bromide/salbutamol administered by MDI. In all of them, soy allergy was substantiated by skin prick test and IgG/IgE RAST. The symptoms quickly disappeared with antihistaminics and nebulized salbutamol.
  
  
  CONCLUSIONS
  In the cases where paradoxical bronchoconstriction and angioedema associated with the use of ipratropium bromide/salbutamol in MDI an immediate hypersentivity reaction to soy was confirmed, which is used as an additive in the MDI, through allergen-specific IgE determination and skin tests.
authors.affiliation: Ignacio Esteva N∞107-206, Col San Miguel Chapultepec, 11850, MÈxico, D.F. blancamorfin@hotmail.com.
authors.forename: Blanca María
authors.initials: BM
authors.lastname: Morfin-Maciel
authors.forename: Blanca María
authors.initials: BM
authors.lastname: Castillo-Morfin
mesh_terms: D000420:Albuterol / Q000627:therapeutic use; D000799:Angioedema / Q000139:chemically induced; D001249:Asthma / Q000188:drug therapy; D016084:Bronchoconstriction; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D009241:Ipratropium; D036501:Metered Dose Inhalers
chemical_list: D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol