A case of oral desensitization for hypersensitivity to exogenous progesterone

Kim, Young-Chan; Choi, Kook-Hwan; Kang, Dong-Yoon; Sohn, Kyung Hee; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

doi:10.4168/aard.2017.5.5.294

Case Report

Open Access


Allergy Asthma Respir Dis. 2017 Sep;5(5):294-297. Korean. Published online September 30, 2017. https://doi.org/10.4168/aard.2017.5.5.294
© 2017 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology


A case of oral desensitization for hypersensitivity to exogenous progesterone
Young-Chan Kim,¹^,² Kook-Hwan Choi,¹ Dong-Yoon Kang,³ Kyung Hee Sohn,¹^,² Sang-Heon Cho,¹^,²^,³ Kyung-Up Min,¹^,² and Hye-Ryun Kang¹^,²^,³
¹Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
²Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
³Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea.
Correspondence to: Hye-Ryun Kang. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-2072-0820, Fax: +82-2-764-2199, Email: helenmed@snu.ac.kr

Received November 22, 2016; Revised December 31, 2016; Accepted January 05, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Go to: Abstract
Hypersensitivity reaction to progesterone is a rare pathologic condition which consists of autoimmune response to endogenous progesterone, known as autoimmune progesterone dermatitis, and hypersensitivity reaction to exogenous progestogen. We report the case of a 31-year-old woman with a history of whole body urticaria during exogenous progesterone supplementation for in vitro fertilization (IVF). She was admitted to the hospital for the diagnosis and management of progestogen hypersensitivity. An intradermal test with progesterone revealed positivity to 5 mg/mL of progesterone. For her next IVF, progesterone desensitization was performed in a method combining oral and intramuscular progesterone administration. After successfully achieving a target dose of 100 mg per day, the route of progesterone administration was converted to intravaginal tablet (90 mg twice a day) without any hypersensitivity reactions.


Keywords: Progesterone; Drug hypersensitivity; Fertilization in vitro; Immunologic desensitization

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Figures


	Fig. 1 Delayed reaction to progesterone after intradermal progesterone skin test.
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Tables


	Table 1 The result of skin prick test and intradermal test with progesterone
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	Table 2 Progesterone desensitization protocol via oral and intramuscular routes
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	Table 3 Summary of reported desensitization protocols for progesterone hypersensitivity
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Notes

This research was supported by a grant from Ministry of Food and Drug Safety to the Regional Pharmacovigilance Center in 2016.

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