title: Three cases of anaphylaxis following injection of a depot corticosteroid with evidence of IgE sensitization to macrogols rather than the active steroid.
abstract: We present three cases with anaphylaxis after injection of a depot corticosteroid. First, the steroid was suspected as the elicitor, but after evaluation the excipient macrogol was found to be the elicitor. One of the patients had reactions to several unrelated drugs. Increased awareness of anaphylaxis to excipients such as macrogols is needed, especially when allergy tests for the active drug is negative and in patients with a history of repeated anaphylaxis to seemingly unrelated drugs. To establish the correct diagnosis it is important to test with the exact formulation of the culprit drug, as well as all the ingredients including excipients.
authors.affiliation: Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Nicolaj
authors.initials: N
authors.lastname: Brandt
authors.affiliation: Department of Dermatology and Allergy, Allergy Clinic, Gentofte Hospital, 2900 Hellerup, Denmark.
authors.forename: Lene H
authors.initials: LH
authors.lastname: Garvey
authors.affiliation: Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Ulla
authors.initials: U
authors.lastname: Bindslev-Jensen
authors.affiliation: Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Henrik Fomsgaard
authors.initials: HF
authors.lastname: Kjaer
authors.affiliation: Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Carsten
authors.initials: C
authors.lastname: Bindslev-Jensen
authors.affiliation: Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Charlotte G
authors.identifier: 0000-0001-8710-0829
authors.initials: CG
authors.lastname: Mortz
keywords: Anaphylaxis; Corticosteroids; Macrogols; Oral challenge; Skin testing