Anaphylaxis to 6-α-methylprednisolone in an eight-year-old child

Abstract

Corticosteroids are widely used in the treatment of several diseases, including allergic or pseudoallergic reactions. It is therefore somewhat ironic that they may be responsible for adverse events and provoke allergic or allergic-like reactions. Allergic reactions to hydrocortisone have been reported since the 1950s. 1,2 These reactions may be immunologic or nonimmunologic in nature, and they are very rare. Allergic contact dermatitis caused by corticosteroids, however, seems to be more common, and prevalences near 4% have been reported in recent studies of patients who have undergone patch testing? Hydrocortisone and methylprednisolone are the most common drugs involved in systemic adverse reactions. Prednisone, betamethasone, and dexamethasone are reported less frequently as causative agents?, 2, 6 Allergic or pseudoallergic reactions to systemic corticosteroid therapy include bronchospasm, ~, 2, 4, 5 urticaria with or without angioedema,1, 2, 6 and anaphylaxis. :l, 2, 7 Previous contact dermatitis resulting from topical corticosteroid therapy may occasionally predispose the patient to a generalized reaction after systemic corticosteroid therapy. 6 We report a case of anaphylaxis resulting from an intramuscular injection of 6-e~-methylprednisolone. Type 1 hypersensitivity was proved by a positive skin test response. Other corticosteroids were tolerated.