Abstract
BackgroundMedications with methyl-prednisolone sodium succinate containing lactose, which potentially contains traces of cow’s milk proteins (CMP), could cause allergic reactions or compromise treatment of acute allergic reactions in sensitized patients.Case presentationWe describe the unusual case of a one-year-old child affected by short bowel syndrome and history of severe cow’s milk allergy (CMA) and anaphylactic reaction due to intravenous administration of methyl-prednisolone sodium succinate (Solu-Medrol 40 mg, Pfizer). He was admitted to our hospital for severe respiratory failure and was initially treated with methyl-prednisolone (Urbason 40 mg, Sanofi Aventis), then with methyl-prednisolone sodium succinate (Solu-Medrol 40 mg, Pfizer). After the intravenous administration of second steroid, immediate anaphylaxis was recorded and treatment was stopped. Antihistamine and epinephrine were required and symptom resolution occurred.ConclusionChildren who are highly sensitive to milk may have severe allergic reactions also after exposure to CMP through a different administration route than the oral one. Patients who have food allergies need to pay particular attention to the prescription of drugs and their formulation.
Highlights
Medications with methyl-prednisolone sodium succinate containing lactose, which potentially contains traces of cow’s milk proteins (CMP), could cause allergic reactions or compromise treatment of acute allergic reactions in sensitized patients.Case presentation: We describe the unusual case of a one-year-old child affected by short bowel syndrome and history of severe cow’s milk allergy (CMA) and anaphylactic reaction due to intravenous administration of methylprednisolone sodium succinate (Solu-Medrol 40 mg, Pfizer)
Due to atopic state and/or bronchial hyperreactivity, some small children may have recurrent episodes of acute wheezing during respiratory infections for which corticosteroids are commonly used. International guidelines such as the Global Initiative for Asthma (GINA) [4] and those by the British Thoracic Society [5] recommend the early use of systemic corticosteroids in acute asthma as it has been shown to reduce hospital admission rate, length of hospitalization and relapse rate after discharge
We describe the case of a oneyear-old child affected by short bowel syndrome (SBS) with history of severe CMA and anaphylactic reaction due to intravenous administration of methyl-prednisolone sodium succinate (Solu-Medrol 40 mg, Pfizer) given for the treatment of viral respiratory illness
Summary
Children who are highly sensitive to milk may have severe allergic reactions after exposure to CMP through a different administration route than the oral one.
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