| Title | Type IV delayed-type hypersensitivity of the respiratory tract due to budesonide use: report of two cases and a literature review. | | Author(s) | Pitsios C, Stefanaki EC, Helbling A | | Institution | Allergy Outpatient Department, Social Insurance Institute, Athens, Greece. | | Source | Prim Care Respir J 2009 Oct 13. | | Abstract | 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(R), 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. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19826744 |
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