Hypersensitivity reactions to high osmolality Total Parenteral Nutrition: a case report.
Hypersensitivity reactions
Osmolality
Total Parenteral Nutrition
Urticaria
Journal
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
ISSN: 1710-1484
Titre abrégé: Allergy Asthma Clin Immunol
Pays: England
ID NLM: 101244313
Informations de publication
Date de publication:
2019
2019
Historique:
received:
25
06
2019
accepted:
21
08
2019
entrez:
6
9
2019
pubmed:
6
9
2019
medline:
6
9
2019
Statut:
epublish
Résumé
The full range of allergic reactions to Total Parenteral Nutrition (TPN) remains unknown. Additionally, beyond individual allergens, there may be other factors contributing to TPN hypersensitivity reactions. We present a case of a patient with negative skin testing to common TPN allergens who had recurrent urticarial reactions to TPN. Her skin reactions resolved once TPN was stopped. Following a literature review, we postulated that the reactions could be due to the high osmolality of her TPN. Consequently, lowering her TPN from 2785 to 1928 mOsm/kg and premedicating with cetirizine resulted in resolution of her urticaria. When looking at patients who have hypersensitivity reactions to TPN, one must consider that their reactions may be due to factors other than allergens. More studies are needed to clarify the relationship between high osmolality TPN infusions and non-IgE mediated hypersensitivity reactions.
Sections du résumé
BACKGROUND
BACKGROUND
The full range of allergic reactions to Total Parenteral Nutrition (TPN) remains unknown. Additionally, beyond individual allergens, there may be other factors contributing to TPN hypersensitivity reactions.
CASE PRESENTATION
METHODS
We present a case of a patient with negative skin testing to common TPN allergens who had recurrent urticarial reactions to TPN. Her skin reactions resolved once TPN was stopped. Following a literature review, we postulated that the reactions could be due to the high osmolality of her TPN. Consequently, lowering her TPN from 2785 to 1928 mOsm/kg and premedicating with cetirizine resulted in resolution of her urticaria.
CONCLUSIONS
CONCLUSIONS
When looking at patients who have hypersensitivity reactions to TPN, one must consider that their reactions may be due to factors other than allergens. More studies are needed to clarify the relationship between high osmolality TPN infusions and non-IgE mediated hypersensitivity reactions.
Identifiants
pubmed: 31485241
doi: 10.1186/s13223-019-0364-z
pii: 364
pmc: PMC6716805
doi:
Types de publication
Case Reports
Langues
eng
Pagination
51Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
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