Immediate hypersensitivity reactions to corticosteroids.

摘要: Abstract Objective To review the literature on immediate hypersensitivity reactions to corticosteroids and classify them according manifestations, routes of exposure, causative preparations, diagnostic tests, management. Data Sources PubMed search for English-language publications from January 1, 2004 through December 31, 2014 using terms corticosteroid, glucocorticoid, or steroid combined with hypersensitivity, allergy, anaphylaxis. Study Selection Only reports that occurred sooner than 24 hours after administration a corticosteroid were included. Excluded patients delayed reactions, including contact dermatitis. Results Forty-eight articles fulfilled criteria, reporting 120 in 106 2 90 years age (55 male 51 female). The most commonly reported manifestation was anaphylaxis 60.8% (73 120) followed by urticaria and/or angioedema 26.7%. Exposure any route, intravenous being common (44.2%, 53 120), oral 25.8% intra-articular 11.7%. Methylprednisolone implicated (40.8%) prednisolone (20.0%). Some reacted more 1 preparation. Pharmacologically-inactive ingredients 28.3%. Diagnosis based primarily medical history cases confirmed challenge testing. Skin tests positive 74.1%. vast majority tolerated at least alternative preparation, very rarely desensitization required. Conclusion Corticosteroids seem be rare causes but possibly are misdiagnosed under-reported relative their worldwide use. Physicians should cognizant this entity identify safe preparations.