Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test

Chlorpheniramine is a widely prescribed H1-antihistamine for relieving urticaria or histamine-mediated allergic reactions. However, although rare, it may cause immediate hypersensitivity reactions. The diagnosis is usually made by provocation test, but its application is often limited due to comorbi...

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Autores principales: Lee, Hyun-Seung, Song, Woo-Jung, Lee, Ji-Won, Cho, Young-Yoon, Park, Han-Ki, Kang, Min-Gyu, Cho, Sang-Heon, Sohn, Seong-Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521167/
https://www.ncbi.nlm.nih.gov/pubmed/26240795
http://dx.doi.org/10.5415/apallergy.2015.5.3.177
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author Lee, Hyun-Seung
Song, Woo-Jung
Lee, Ji-Won
Cho, Young-Yoon
Park, Han-Ki
Kang, Min-Gyu
Cho, Sang-Heon
Sohn, Seong-Wook
author_facet Lee, Hyun-Seung
Song, Woo-Jung
Lee, Ji-Won
Cho, Young-Yoon
Park, Han-Ki
Kang, Min-Gyu
Cho, Sang-Heon
Sohn, Seong-Wook
author_sort Lee, Hyun-Seung
collection PubMed
description Chlorpheniramine is a widely prescribed H1-antihistamine for relieving urticaria or histamine-mediated allergic reactions. However, although rare, it may cause immediate hypersensitivity reactions. The diagnosis is usually made by provocation test, but its application is often limited due to comorbidities or potential risk of severe reactions. In those cases, skin tests and basophil activation tests can be considered as additional diagnostic tests for the drug allergy. Here, we report a 33-year-old female with underlying chronic urticaria, who recurrently developed anaphylaxis after chlorpheniramine administration. Intradermal test showed positive responses in the patient at 0.02 mg/mL of chlorpheniramine, but not in healthy controls. Basophil activation test showed significant up-regulation of CD63 and CD203c by chlorpheniramine. The present case reminds the rare but potential allergic risk of chlorpheniramine, and also suggests the potential utility of basophil activation test in making the diagnosis.
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spelling pubmed-45211672015-08-03 Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test Lee, Hyun-Seung Song, Woo-Jung Lee, Ji-Won Cho, Young-Yoon Park, Han-Ki Kang, Min-Gyu Cho, Sang-Heon Sohn, Seong-Wook Asia Pac Allergy Hypothesis & Experience Chlorpheniramine is a widely prescribed H1-antihistamine for relieving urticaria or histamine-mediated allergic reactions. However, although rare, it may cause immediate hypersensitivity reactions. The diagnosis is usually made by provocation test, but its application is often limited due to comorbidities or potential risk of severe reactions. In those cases, skin tests and basophil activation tests can be considered as additional diagnostic tests for the drug allergy. Here, we report a 33-year-old female with underlying chronic urticaria, who recurrently developed anaphylaxis after chlorpheniramine administration. Intradermal test showed positive responses in the patient at 0.02 mg/mL of chlorpheniramine, but not in healthy controls. Basophil activation test showed significant up-regulation of CD63 and CD203c by chlorpheniramine. The present case reminds the rare but potential allergic risk of chlorpheniramine, and also suggests the potential utility of basophil activation test in making the diagnosis. Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2015-07 2015-07-29 /pmc/articles/PMC4521167/ /pubmed/26240795 http://dx.doi.org/10.5415/apallergy.2015.5.3.177 Text en Copyright © 2015. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Hypothesis & Experience
Lee, Hyun-Seung
Song, Woo-Jung
Lee, Ji-Won
Cho, Young-Yoon
Park, Han-Ki
Kang, Min-Gyu
Cho, Sang-Heon
Sohn, Seong-Wook
Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title_full Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title_fullStr Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title_full_unstemmed Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title_short Chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
title_sort chlorpheniramine-induced anaphylaxis diagnosed by basophil activation test
topic Hypothesis & Experience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521167/
https://www.ncbi.nlm.nih.gov/pubmed/26240795
http://dx.doi.org/10.5415/apallergy.2015.5.3.177
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