Severe hypersensitivity reactions to corticosteroids in children

Pediatr Emerg Care. 2009 May;25(5):339-41. doi: 10.1097/PEC.0b013e3181a34901.

Abstract

Objective: To present 3 children with hypersensitivity reaction to methylprednisolone sodium-succinate and review the literature regarding such reactions.

Methods: Data on the clinical features were obtained from the children's files. Skin prick tests were performed with a panel of corticosteroid preparations.

Results: Three patients (5, 7, and 8 years) with asthma who were treated with intravenous methylprednisolone succinate at the emergency department developed hypersensitivity reactions initially consider to be due to their primary disease. Two had a positive skin prick test to methylprednisolone sodium succinate but not to other corticosteroids or to the succinate ester. Skin prick tests to different corticosteroids, performed 4 years after the event in the third patient, were negative.

Conclusions: Methylprednisolone sodium-succinate may cause anaphylactic/anaphylactoid reactions in children. Our patients' histories emphasize the importance of awareness to corticosteroid-induced reactions, especially in children with asthma in whom the symptoms may be considered as an exacerbation of their primary illness.

Publication types

  • Case Reports

MeSH terms

  • Anaphylaxis / chemically induced*
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects*
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / complications
  • Asthma / diagnosis
  • Asthma / drug therapy
  • Child
  • Child, Preschool
  • Diagnostic Errors
  • Drug Eruptions / etiology
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / etiology*
  • Emergencies
  • Facial Dermatoses / chemically induced
  • Humans
  • Infusions, Intravenous
  • Intradermal Tests
  • Methylprednisolone Hemisuccinate / adverse effects*
  • Milk Hypersensitivity / complications
  • Milk Hypersensitivity / diagnosis
  • Milk Hypersensitivity / drug therapy

Substances

  • Anti-Asthmatic Agents
  • Methylprednisolone Hemisuccinate