title: Allergic Reaction to Polyether Ether Ketone Following Cross-Reactivity to Epoxy Resin.
abstract: Polyether ether ketone (PEEK) is a thermoplastic polymer frequently used in engineering but also in medical devices. Only 1 case of allergic reaction to PEEK used as an implanted medical device has been reported so far; however, the route of sensitization remained unclear. Here we report on a 62-year-old male patient with a preknown, severe type IV allergy to epoxy resin. He reported strong pain in his shoulder after implantation of a PEEK-containing device after a rotator cuff injury. For testing, the device was implanted in a small pouch subcutaneously on the abdomen. The patient reported massive pain starting 8 hours after the implantation, strictly limited to the procedural area and showing perifocal erythema. A possible explanation of the sensitization mode is the source material for PEEK and epoxy resin, as both are mainly based on bisphenols. An allergic reaction to PEEK with preknown epoxy resin sensitization has not been reported so far. As epoxy resins are a frequent cause of occupational contact dermatitis and PEEK is widely used for medical and nonmedical devices, we believe that this is of great clinical relevance.
authors: 1 Department of Dermatology, Eberhard-Karls University, Tübingen, Germany.|2 Private Outpatient Clinic for Allergy and Dermatology, Hall in Tirol, Austria.
authors: Lukas
authors: L
authors: Kofler
authors: 3 Department of Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Innsbruck, Austria.
authors: Markus
authors: M
authors: Wambacher
authors: 1 Department of Dermatology, Eberhard-Karls University, Tübingen, Germany.
authors: Katrin
authors: K
authors: Schweinzer
authors: 2 Private Outpatient Clinic for Allergy and Dermatology, Hall in Tirol, Austria.
authors: Maritta
authors: M
authors: Scherl
authors: 2 Private Outpatient Clinic for Allergy and Dermatology, Hall in Tirol, Austria.
authors: Heinz
authors: H
authors: Kofler
mesh_terms: D001577:Benzophenones; D003429:Cross Reactions; D020878:Device Removal; D004853:Epoxy Resins / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007659:Ketones / Q000009:adverse effects* / Q000737:chemistry / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000737:chemistry; D011108:Polymers; D011183:Postoperative Complications / Q000139:chemically induced*; D020069:Shoulder Pain / Q000139:chemically induced; D000072227:Shoulder Prosthesis / Q000009:adverse effects*
chemical_list: D001577:Benzophenones; D004853:Epoxy Resins; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols
keywords: allergy; cross-reactivity; epoxy resin