title: [Utility of challenge test in immediate hypersensitivity to hydrocortisone sodium succinate].
abstract: Corticosteroid hypersensitivity is a complex phenomenon in which many factors interact, such as idiosyncrasy, intolerance or allergic reactions. The prevalence of immediate hypersensitivity reactions to corticosteroids is 0.2%-0.5%. Corticosteroids have major therapeutic implications; thus, when hypersensitivity is suspected, in-vitro and/or in-vivo testing can be performed to confirm diagnosis, being the drug challenge the gold standard. After definitive diagnosis, cross-reactivity among the different corticosteroid groups should be considered, to choose wisely if corticosteroid therapy is still required. In Coopman classification, steroids belonging to groups A, B and D2 have high cross-reactivity, however, more studies are needed to determine the degree of cross-reaction among these drugs. This paper presents the case of a woman, in who hypersensitivity to hydrocortisone succinate was confirmed by drug challenge test.
authors.affiliation: Servicio de Alergia e Inmunología Clínica, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, IMSS, México, DF. adelaamaya@hotmail.com.
authors.forename: Adela Sisy
authors.initials: AS
authors.lastname: Amaya-Mejía
authors.forename: Lucy Vania
authors.initials: LV
authors.lastname: Galindo-Pacheco
authors.forename: Patricia María
authors.initials: PM
authors.lastname: O'Farrill-Romanillos
authors.forename: Karen Alicia
authors.initials: KA
authors.lastname: Rodríguez-Mireles
authors.forename: Freya Helena
authors.initials: FH
authors.lastname: Campos-Romero
authors.forename: Leonel
authors.initials: L
authors.lastname: del Rivero-Hernández
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000737:chemistry / Q000145:classification / Q000276:immunology / Q000493:pharmacokinetics; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced; D000799:Angioedema / Q000139:chemically induced; D003429:Cross Reactions; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006241:Haptens / Q000276:immunology; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D015394:Molecular Structure; D013329:Structure-Activity Relationship
chemical_list: D000305:Adrenal Cortex Hormones; D006241:Haptens; C007133:hydrocortisone hemisuccinate; D006854:Hydrocortisone
keywords: Corticosteroids; Cross-reactivity; Drug challenge test; Hypersensitivity