Type IV delayed-type hypersensitivity of the respiratory tract due to budesonide use: report of two cases and a literature review

Pitsios, Constantinos; Stefanaki, Efthalia C; Helbling, Arthur (2010). Type IV delayed-type hypersensitivity of the respiratory tract due to budesonide use: report of two cases and a literature review. Primary care respiratory journal, 19(2), pp. 185-8. Birmingham: General Practice Airways Group

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Respiratory type-IV hypersensitivity reactions due to corticosteroids is a rare phenomenon. We describe two such cases. The first is a 37- year-old atopic woman who developed labial angioedema and nasal itching after the use of budesonide nasal spray. A month later, after the first puffs of a formoterol/budesonide spray prescribed for asthma, she noticed symptoms of tongue and oropharyngeal itching and redness with subsequent dysphagia, labial and tongue angioedema, and facial oedema. The second is a 15-year-old non-atopic woman who reported pruritic eruptions around the nostrils after using a budesonide nasal spray. A year later she presented with nasal pruritus with intense congestion and labial and facial oedema after using the same spray. Both patients were evaluated with patch-tests using the commercial T.R.U.E. test, a budesonide solution, and corticosteroid creams. Test evaluation was performed at 48 and 96 hours. In both patients, patch tests were positive to budesonide (++) on the second day. The first patient also had a positive (+) reaction to tixocortol-21-pivalate. All the other patch tests were negative. Clinicians should be aware that hypersensitivity reactions may occur during the use of nasal or inhaled corticosteroids.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Helbling, Arthur

ISSN:

1471-4418

Publisher:

General Practice Airways Group

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:07

Last Modified:

05 Dec 2022 14:00

PubMed ID:

19826744

URI:

https://boris.unibe.ch/id/eprint/105 (FactScience: 195932)

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