title: Immediate-type hypersensitivity reaction to Mannitol as drug excipient (E421): a case report.
abstract: Allergic reactions to mannitol have been reported rarely, despite its widespread use as a drug and as a food excipient. This is the first case report in which oral mannitol induces an immediate type hypersensitivity as a drug excipient, in a 42 year old man affected by rhinitis to olive tree pollen. Unusual and undervalued risk factors for mannitol hypersensitivity are examined.
authors.affiliation: Pneumology Department, Hospital Ninetto Melli, San Pietro Vernotico, Brindisi, Italy. Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. E-mail: gf.calogiuri@libero.it.
authors.forename: G F
authors.initials: GF
authors.lastname: Calogiuri
authors.affiliation: Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Muratore
authors.affiliation: Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Nettis
authors.affiliation: Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Casto
authors.affiliation: Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Di Leo
authors.affiliation: Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vacca
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005079:Excipients / Q000008:administration & dosage / Q000009:adverse effects*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007159:Immunologic Tests; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D005079:Excipients; D006633:Histamine Antagonists; D008353:Mannitol
keywords: Excipient; Mannitol; Olive tree pollen; Oral challenge test; Paracetamol; Rhinitis; Urticaria