Allergie à l’hemisuccinate de methylprednisolone chez une patiente atteinte d’une dysfonction des cordes vocales à l’effort

Abstract

Vocal cord dysfunction, defined as involuntary folding of the vocal cords during inhalation resulting in sudden inspiratory dyspnoea, is rare. Diagnosis is difficult due to more frequent potential differential diagnoses, including asthma. Hypersensitivity to systemic glucocorticosteroids is another rare disease. Herein we report the case of a 19-year old girl, initially consulting for asthma, who presented several episodes of brutal inspiratory dyspnoea followed by generalized urticaria during sports activities. The allergy, respiratory and ear/nose/throat work-up made us suspect a vocal cord dysfunction associated with an immediate IgE-mediated allergy to méthylprednisolone hemisuccinate (with tolerance to prednisolone and méthylprednisolone). Treatment consisted of speech therapy, contraindication to sports, and withdrawal of méthylprednisolone hemisuccinate. No relapses occurred during follow-up.