Utility of challenge test in immediate hypersensitivity to hydrocortisone sodium succinate

• Published in: Revista alergia Mexico (Tecamachalco, Pueblo, Mexico : 1993) Vol. 61; no. 1; pp. 32 - 37
• Main Authors: Amaya-Mejía, Adela Sisy, Galindo-Pacheco, Lucy Vania, O'Farrill-Romanillos, Patricia María, Rodríguez-Mireles, Karen Alicia, Campos-Romero, Freya Helena, del Rivero-Hernández, Leonel
• Format: Journal Article
• Language: Spanish; English
• Published: Mexico Colegio Mexicano de Inmunología Clínica y Alergia, A.C 01.01.2014
• Subjects: Administration, Oral; Adrenal Cortex Hormones - chemistry; Adrenal Cortex Hormones - classification; Adrenal Cortex Hormones - immunology; Adrenal Cortex Hormones - pharmacokinetics; Adult; Anaphylaxis - chemically induced; Angioedema - chemically induced; corticoesteroides; Cross Reactions; Dose-Response Relationship, Drug; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - etiology; Drug Hypersensitivity - physiopathology; Female; Haptens - immunology; hipersensibilidad; Humans; Hydrocortisone - administration & dosage; Hydrocortisone - adverse effects; Hydrocortisone - analogs & derivatives; Hydrocortisone - immunology; Hypersensitivity, Immediate - chemically induced; Hypersensitivity, Immediate - diagnosis; Hypersensitivity, Immediate - physiopathology; Molecular Structure; prueba de reto; reactividad cruzada; Structure-Activity Relationship; Corticosteroids; Drug challenge test; Cross-reactivity; Hypersensitivity
• ISSN: 0002-5151; 2448-9190
• DOI: 10.29262/ram.v61i1.19

Corticosteroid hypersensitivity is a complex phenomenon in which many factors interact, such as idiosyncrasy, intolerance or allergic reactions. The prevalence of immediate hypersensitivity reactions to corticosteroids is 0.2%-0.5%. Corticosteroids have major therapeutic implications; thus, when hypersensitivity is suspected, in-vitro and/or in-vivo testing can be performed to confirm diagnosis, being the drug challenge the gold standard. After definitive diagnosis, cross-reactivity among the different corticosteroid groups should be considered, to choose wisely if corticosteroid therapy is still required. In Coopman classification, steroids belonging to groups A, B and D2 have high cross-reactivity, however, more studies are needed to determine the degree of cross-reaction among these drugs. This paper presents the case of a woman, in who hypersensitivity to hydrocortisone succinate was confirmed by drug challenge test.