Immediate hypersensitivity reaction to polyethylene glycol 3350

Seung-Eun Lee; Ju-Young Kim; Suh-Young Lee; Su-Jeong Kim; Hye-Ryun Kang

doi:10.4168/aard.2015.3.4.307

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Lee, Kim, Lee, Kim, and Kang: Immediate hypersensitivity reaction to polyethylene glycol 3350

Case Report

Allergy, Asthma & Respiratory Disease 2015; 3(4): 307-309.

Published online: 28 July 2015

DOI: https://doi.org/10.4168/aard.2015.3.4.307

Immediate hypersensitivity reaction to polyethylene glycol 3350

Seung-Eun Lee^1,², Ju-Young Kim^1,^3,⁴, Suh-Young Lee^1,^4,⁵, Su-Jeong Kim^1,⁶, Hye-Ryun Kang^1,^3,⁴

¹Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.

²Respirology and Allergy Clinic, Pusan National University Yangsan Hospital, Yangsan, Korea.

³Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea.

⁴Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

⁵Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.

⁶Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Correspondence to: Hye-Ryun Kang. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-0820, Fax: +82-2-742-3291, helenmed@snu.ac.kr

Received 14 May 2015 Revised 26 May 2015 Accepted 26 May 2015

(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

Polyethylene glycol (PEG) 3350 is the main ingredient of oral solutions for bowel preparation prior to colonoscopy. This high-molecular-weight PEG has shown a low incidence of adverse reactions because of its low absorption via the intestine. Systemic allergic reactions to PEG solution are very rare, and only 10 cases have been reported in the literature worldwide. We experienced a case of immediate hypersensitivity reaction to PEG 3350. A 35-year-old male patient was prescribed PEG 3350 solution for colonoscopy. After ingestion of 2.5 pack (55 g of PEG 3350 powder), he began to show urticaria on both arms and trunk, and swelling in the lips. Symptoms resolved over the next few hours without any treatment. Skin prick and intradermal tests with PEG 3350 showed positive responses to both test. We also performed oral provocation tests with PEG 3350. Thirty minutes after ingestion of 2.5 g of PEG 3350 powder, the patient presented with mild urticaria and angioedema. Finally he was diagnosed with immediate hypersensitivity reaction by PEG 3350. The patient underwent colonoscopy after preparation with sodium phosphate solution without any adverse reactions. We herein report the first case of PEG 3350-induced immediate hypersensitivity reaction confirmed by skin and oral provocation tests in Korea.

Keywords: Immediate hypersensitivity, Polyethylene glycols, Skin tests

Figures and Tables

Fig. 1

Photos of skin tests using polyethylene glycol (PEG) 3350. Positive responses were observed in prick test (A) and intradermal test (B). H, histamine; S, saline.

Table 1

Skin test results using PEG 3350

Test	Wheal (mm)	Flare (mm)
Skin prick test
Histamine	4.0 × 4.0	5.0 × 5.0
Saline	0× 0	0× 0
PEG 3350 (100 mg/mL)	4.0 × 2.0	5.0 × 3.0
Intradermal test
Saline	No increase	0× 0
PEG 3350 (1 mg/mL)	9.0 × 8.0	15.0 × 15.0

PEG, polyethylene glycol.

Notes

This study was supported by a grant from Ministry of Food and Drug Safety to operation of the Regional Pharmacovigilance Center in 2015.

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ORCID iDs: Hye-Ryun Kang
https://orcid.org/http://orcid.org/0000-0002-2317-4201
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