Abstract
We report on patient with asthma who developed severe anaphylactic reaction to intravenous hydrocortisone.
A 18-years old man complained nasal itching, chest tightness, choking sensation immediately after intravenous Solu-cortef injection for an acute asthma attack. Cyanosis and exacervation of asthma symptom were also observed and he was transfered to our hospital.
Suspecting that the symptoms were induced by a preservative, paraben, contained in Solu-Cortef, we administered another hydrocortisone prepatation without paraben, Saxizon, which again resulted in exacervation.
After the patient was recoverd, we investigated etiology of the reaction.
Intradermal skin test was positive to hydrocortisone, methylprednisolone, and dexamethasone. Prausnitz-Kustner (P-K) test was also positive to hydrocortisone and methylprednisolone. Absorbtion of IgE from patient serum by affinity chromatography abolished the reaction in P-K test.
There results suggest that the patient had IgE antibody to hydrocortison, which possibly caused severe anaphylactic reaction.
