title: IgE-mediated allergic reactions after the first administration of glatiramer acetate in patients with multiple sclerosis.
abstract: BACKGROUND
  Immediate adverse reactions to glatiramer acetate (GA), a drug used in the treatment of patients with multiple sclerosis (MS), have been poorly investigated. We studied 3 MS patients who presented adverse reactions following GA administration. Two of them experienced severe anaphylactic reactions after the first administration and the other an eyelid edema upon reintroduction 6 months after GA withdrawal.
  
  
  METHODS
  Skin prick tests (SPT) to GA and mannitol were performed on all 3 patients and in 10 atopic controls. Specific IgE (sIgE) levels to GA, myelin basic protein (MBP) and MBP fragments were assessed in all 3 patients, 6 MS patients treated with GA for more than 6 month and 10 healthy donors. Specific IgG (sIgG) to GA was also quantified in the three study groups. Both sIgE and sIgG were determined by means of the UniCAP 100 assay.
  
  
  RESULTS
  SPT and sIgE to GA were positive only in the 3 patients with adverse reactions while sIgE to mannitol was negative in all. sIgE tests against MBP and its fragments were negative in all individuals. Similar levels of sIgG to GA were found in all studied subjects.
  
  
  CONCLUSIONS
  These results demonstrate the significance of sIgE in allergic reactions to GA presented by these patients and suggest the importance of strict surveillance during administration of the first GA doses.
authors: Division of Allergology, Department of Internal Medicine, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
authors: Mercè
authors: M
authors: Corominas
authors: Idoia
authors: I
authors: Postigo
authors: Victoria
authors: V
authors: Cardona
authors: Ramon
authors: R
authors: Lleonart
authors: Lucía
authors: L
authors: Romero-Pinel
authors: Jorge
authors: J
authors: Martinez
mesh_terms: D000707:Anaphylaxis / Q000209:etiology*; D000068717:Glatiramer Acetate; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000276:immunology; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D010455:Peptides; D007073:Immunoglobulin E; D000068717:Glatiramer Acetate