Abstract
IntroductionThis case report presents for the first time an acute systemic allergic reaction to corticosteroids in a patient with ocular toxoplasmosis after treatment with intravenous cortisone, and discusses alternative treatments.Case presentationWe present the case of a 57-year-old Caucasian woman with an anaphylactic reaction after intravenous injection of prednisolone-21-hydrogensuccinate (Solu-Decortin® H) given for the treatment of toxoplasmosis-associated chorioretinitis. Immediately after the injection, she developed an acute erythema of the legs and abdomen, angioedema, hypotension (blood pressure 80/40mmHg), tachycardia (heart rate 140/minute), hyperthermia (38.8°C), and respiratory distress. Allergological examinations showed a positive skin-prick test to prednisolone and methylprednisolone. In addition, an oral exposure test with dexamethasone (Fortecortin®) and betamethasone (Celestamine®) was conducted to find alternative corticosteroids for future treatments. After oral application, no local or systemic reactions were observed for these two substances.ConclusionsThis case report demonstrates that systemic allergic reactions are possible in patients with uveitis or other inflammatory ophthalmological conditions treated with intravenous corticosteroids. Intravenous administration of cortisone, for example, in the treatment of ocular toxoplasmosis, should always be conducted with caution because of a possible allergic reaction. For patients who react to a particular steroid, it is necessary to undergo allergological testing to confirm that the compound in question is indeed allergenic, and to identify other corticosteroids that are safe for future anti-inflammatory treatments.
Highlights
This case report presents for the first time an acute systemic allergic reaction to corticosteroids in a patient with ocular toxoplasmosis after treatment with intravenous cortisone, and discusses alternative treatments.Case presentation: We present the case of a 57-year-old Caucasian woman with an anaphylactic reaction after intravenous injection of prednisolone-21-hydrogensuccinate (Solu-Decortin® H) given for the treatment of toxoplasmosis-associated chorioretinitis
This case report demonstrates that systemic allergic reactions are possible in patients with uveitis or other inflammatory ophthalmological conditions treated with intravenous corticosteroids
For patients who react to a particular steroid, it is necessary to undergo allergological testing to confirm that the compound in question is allergenic, and to identify other corticosteroids that are safe for future anti-inflammatory treatments
Summary
This case report demonstrates that systemic allergic reactions are possible in patients with uveitis or other inflammatory ophthalmological conditions treated with intravenous corticosteroids. SH has made substantial contributions to the article, and he has been involved in drafting the manuscript and revising it critically. AFe has made substantial contributions to the article, and he has been involved in drafting the manuscript and revising it critically. IF has been involved in drafting the manuscript and revising it critically and has given final approval of the version to be published. UHS has been involved in drafting the manuscript and revising it critically and has given final approval of the version to be published. Author details 1Department of Ophthalmology, Dr Horst-Schmidt-Clinics, Wiesbaden, Germany. Author details 1Department of Ophthalmology, Dr Horst-Schmidt-Clinics, Wiesbaden, Germany. 2Department of Dermatology, Dr Horst-Schmidt-Clinics, Wiesbaden, Germany. 3Center of Ophthalmology, Ingelheim, Germany
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
