Simultaneous positive patch test reactions to neomycin and low-molecular-weight heparins: possible cross-reaction?


Journal

European journal of dermatology : EJD
ISSN: 1952-4013
Titre abrégé: Eur J Dermatol
Pays: France
ID NLM: 9206420

Informations de publication

Date de publication:
01 Dec 2021
Historique:
pubmed: 17 12 2021
medline: 22 2 2022
entrez: 16 12 2021
Statut: ppublish

Résumé

A patient received enoxaparin sodium subcutaneous injections for prophylaxis after surgery and developed inflammatory skin reactions on injection sites on Day 5 after the first administration. Patch test was performed with baseline series and low-molecular-weight heparins (LMWHs) at different concentrations and showed positive reactions to neomycin and LMWHs. Cross-reactivity between neomycin and LMWHs was suspected due to similar structure. To establish the evidence of possible cross reaction between neomycin and LMWHs by patch testing. Patch testing of 12 individual controls with a history of neomycin contact allergy was performed. Positive patch test reactions to enoxaparin sodium, tinzaparin sodium, and neomycin sulphate were reported in the patients. None of the controls reacted to LMWHs. There was no proof of cross reaction between neomycin and LMWHs in this study, suggesting that the simultaneous reaction may be a coincidence. Since the number of individuals studied was low, allergy to LMWHs following injection in individuals with a history of neomycin allergy should be further investigated.

Sections du résumé

BACKGROUND BACKGROUND
A patient received enoxaparin sodium subcutaneous injections for prophylaxis after surgery and developed inflammatory skin reactions on injection sites on Day 5 after the first administration. Patch test was performed with baseline series and low-molecular-weight heparins (LMWHs) at different concentrations and showed positive reactions to neomycin and LMWHs. Cross-reactivity between neomycin and LMWHs was suspected due to similar structure.
OBJECTIVES OBJECTIVE
To establish the evidence of possible cross reaction between neomycin and LMWHs by patch testing.
MATERIALS & METHODS METHODS
Patch testing of 12 individual controls with a history of neomycin contact allergy was performed.
RESULTS RESULTS
Positive patch test reactions to enoxaparin sodium, tinzaparin sodium, and neomycin sulphate were reported in the patients. None of the controls reacted to LMWHs.
CONCLUSION CONCLUSIONS
There was no proof of cross reaction between neomycin and LMWHs in this study, suggesting that the simultaneous reaction may be a coincidence. Since the number of individuals studied was low, allergy to LMWHs following injection in individuals with a history of neomycin allergy should be further investigated.

Identifiants

pubmed: 34911671
pii: ejd.2021.4164
doi: 10.1684/ejd.2021.4164
doi:

Substances chimiques

Anti-Bacterial Agents 0
Anticoagulants 0
Enoxaparin 0
enoxaparin sodium 8NZ41MIK1O
Neomycin I16QD7X297

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

741-743

Auteurs

Thanisorn Sukakul (T)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden, Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Cecilia Svedman (C)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.

Jakob Dahlin (J)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.

Ola Bergendorff (O)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.

Lena Holmström (L)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.

Magnus Bruze (M)

Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.

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Classifications MeSH