Drug hypersensitivity to various antihistamines with cross-reactions

Young Uck Kim; Jaechun Lee

doi:10.4168/aard.2014.2.2.134

Journal List > Allergy Asthma Respir Dis > v.2(2) > 1059012

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Kim and Lee: Drug hypersensitivity to various antihistamines with cross-reactions

Case Report

Allergy, Asthma & Respiratory Disease 2014; 2(2): 134-137.

Published online: 31 May 2014

DOI: https://doi.org/10.4168/aard.2014.2.2.134

Drug hypersensitivity to various antihistamines with cross-reactions

Young Uck Kim, Jaechun Lee

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

Correspondence to: Jaechun Lee. Department of Internal Medicine, Jeju National University School of Medicine, 102 Jejudaehak-ro, Jeju 690-756, Korea. Tel: +82-64-754-8170, Fax: +82-64-725-2593, doc4u@hanmail.net

Received 21 July 2013 Revised 2 September 2013 Accepted 17 September 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Antihistamines (histamine receptor antagonists) are widely prescribed medicines in the treatment of allergic disorders, especially the symptoms of hypersensitivity reactions, mainly blocking the activity of vasoactive amines to their receptors. Drug adverse reactions such as sleepiness and dry mouth are frequently encountered. However, drug hypersensitivity provoking itchy hives by antihistamines were rarely reported. A 41-year-old female patient visited allergy clinic for generalized itchy hives from time to time, which had been aggravated 3 months before. Whenever she was exposed to antihistamines for treatment, she felt her hives got immediately full-blown. As a screening, she was tested with various antihistamines on her skin, then skin test-negative antihistamines were orally administered. Finally we failed to choose a safe antihistamine for the treatment of her symptoms. We report a case of drug hypersensitivity to various antihistamines with cross-reactions in a patient with chronic urticaria.

Keywords: Histamine antagonists, Urticaria, Drug hypersensitivity, Cross reactions

Figures and Tables

Fig. 1

Intradermal tests with various antihistamines. Wheal and flare reaction represented positive reaction except for Levocetirizine, Loratadine and the negative control (1, 0.9% saline as a negative control; 3, Chlorpheniramine; 4, Cetirizine; 5, Hydroxyzine; 6, Levocetirizine; 7, Ketotifen; 8, Loratadine; 9, Olopatadine; 11, Azelastine; 13, Cimetidine; 14, Ranitidine).

Table 1

Various antihistamines were tested in skin prick tests, intradermal tests and oral provocation tests

N, negative reaction; +, positive reaction; blank, not done.

Notes

This research was supported by the 2014 Scientific Promotion Program funded by Jeju National University.

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