PSEUDO-ALLERGIC REACTIONS TO CORTICOSTEROIDS - DIAGNOSIS AND ALTERNATIVES

Two patients treated with parenteral paramethasone (Triniol) and dexam ethasone (Sedionbel) are described. A few minutes after administration of the dregs, they presented urticaria (patients 1 and 2) and conjunc tivitis (patient 1). The purpose of our study was to determine the cau se of the patients' reactions, the immunological mechanisms involved a nd whether these patients would be able to tolerate any kind of cortic oid. Clinical examinations and skin, oral and parenteral challenges wi th different corticosteroids and ELISA tests were performed In the two patients, skin and ELISA tests with paramethasone were negative, as w as the prick test with each of its excipients. A single-blind parenter al challenge with Triniol was positive in both patients after the admi nistration of 1 mi of the drug, and negative with its excipients. We a lso carried out oral and parenteral challenges with other corticostero ids and found intolerance to some of them. These results suggest that paramethasone caused pseudoallergic reactions in our patients. Cortico steroids different from paramethasone also produced hypersensitivity r eactions in these patients; however, a few of them were tolerated. The basic mechanisms of those reactions are not yet fully understood. To our knowledge, this is the first report of a pseudo-allergy caused by paramethasone.