Abstract
Aim of the studyOn the basis of the confirmation of an allergy to pholcodine, we tested a possible potential sensitization to neuro-muscular blockers (NMB). Material and methodsA 47-year-old man has experienced a severe reaction 15minutes after having taken a spoon of Biocalyptol® sirup containing pholcodine. It was explored by prick tests and IDR in case of negative pricks (for NMB), basophil activation by flow cytometry (protocol IgE/CCR3/CD63) and quaternary ammonium specific IgE (UniCap Phadia). ResultsA first exploration, performed six weeks after the reaction, showed prick tests and flow cytometry positive for pholcodine (against two controls) and a high level of anti-quaternary ammonium specific IgE (54,1 kU/l). Two weeks after, this patient was tested for NMB and skin tests were positive for suxamethonium, rocuronium and pancuronium and flow cytometry was positive for suxamethonium, rocuronium, pancuronium and atracurium. ConclusionsObservation of positive skin tests, flow cytometry and quaternary ammonium specific IgE in a patient having a pholcodine allergy without previous anaesthesia.
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