FD&C YELLOW #6 HYPERSENSITIVITY UNVEILED IN A PATIENT TREATED WITH CHLORAPREP™ HI-LITE ORANGE

Abstract

<h3>Introduction</h3> FD&C Yellow #6, also known as sunset yellow, is an FDA-approved azo dye commonly used as a coloring agent. We present a case of FD&C Yellow #6 hypersensitivity uncovered by SOAT (single-open application testing) in a patient who underwent coronary angiography. <h3>Case Description</h3> A 60-year-old male presented with chest pain and admitted for management of myocardial infarction. He underwent coronary angiography and developed an urticarial eruption on his right forearm where an IV was placed for intraprocedural heparinization. Upon examination, urticarial lesions were located where ChloraPrep™ Hi-Lite Orange was used to disinfect the IV insertion site. SOAT was performed with both ChloraPrep™ Clear (containing chlorhexidine gluconate 2% w/v, isopropyl alcohol 70% v/v, and purified water) and ChloraPrep™ Hi-Lite Orange (containing chlorhexidine gluconate 2% w/v, isopropyl alcohol 70% v/v, FD&C Yellow #6 dye, and purified water). Within minutes, a reproducible urticarial eruption was noted at the ChloraPrep™ Hi-Lite Orange site, thus FD&C Yellow #6 dye was determined to be the culprit agent. <h3>Discussion</h3> FD&C Yellow #6 is a common ingredient approved by the FDA for use in popular foods and drinks to produce a yellow-orange color (including SunnyD® Tangy Orange Citrus Punch, Gatorade® Orange, and Doritos® Nacho Cheese flavored chips). This dye is also used as a coloring agent in medications and cosmetics. There is a paucity of literature related to FD&C Yellow #6 hypersensitivity and studies on its role in urticaria and angioedema are flawed. This report highlights the need for further research into adverse reactions related to food-grade dyes used in medical environments.