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Anaphylaxis to riboflavin (vitamin B2).

Abstract

BACKGROUND

Vitamin supplements are used more commonly in normal healthy subjects than in patients with vitamin deficiency. Thiamine (vitamin B,) is the vitamin that most frequently induces allergic reactions. To the best of our knowledge, no case of anaphylaxis to riboflavin (vitamin B2) has thus far been reported in the literature.

OBJECTIVE

We describe a previously healthy 15-year-old boy in whom anaphylaxis developed several times after he drank one soft drink or took a single multivitamin tablet. This study was done to determine which of the many components found in the soft drink and vitamin tablet caused the anaphylactic reaction.

METHODS

In an outpatient clinic with the availability of complete resuscitative procedures, we performed single-blind prick skin tests and intradermal skin tests on the patient with various pure vitamin components of the soft drink and the multivitamin tablet. Physiologic saline and histamine were used for negative and positive controls, respectively.

RESULTS

Riboflavin, a component of both the soft drink and the vitamin tablet, produced positive reactions on intradermal skin tests in the patient. Positive reactions were not present in the normal control subjects.

CONCLUSIONS

Riboflavin is a previously unreported cause of anaphylaxis. Free-form riboflavin may potentially be associated with an anaphylactic reaction. It is a vitamin widely used in many patients with chronic disease and in healthy subjects. Vitamin B2 must be considered as a cause of anaphylaxis.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Taoyuan, Taiwan.

    ,

    Source

    MeSH

    Adolescent
    Anaphylaxis
    Carbonated Beverages
    Dietary Supplements
    Humans
    Male
    Riboflavin
    Skin Tests

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    11730188

    Citation

    Ou, L S., et al. "Anaphylaxis to Riboflavin (vitamin B2)." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 87, no. 5, 2001, pp. 430-3.
    Ou LS, Kuo ML, Huang JL. Anaphylaxis to riboflavin (vitamin B2). Ann Allergy Asthma Immunol. 2001;87(5):430-3.
    Ou, L. S., Kuo, M. L., & Huang, J. L. (2001). Anaphylaxis to riboflavin (vitamin B2). Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 87(5), pp. 430-3.
    Ou LS, Kuo ML, Huang JL. Anaphylaxis to Riboflavin (vitamin B2). Ann Allergy Asthma Immunol. 2001;87(5):430-3. PubMed PMID: 11730188.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anaphylaxis to riboflavin (vitamin B2). AU - Ou,L S, AU - Kuo,M L, AU - Huang,J L, PY - 2001/12/4/pubmed PY - 2002/1/5/medline PY - 2001/12/4/entrez SP - 430 EP - 3 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann. Allergy Asthma Immunol. VL - 87 IS - 5 N2 - BACKGROUND: Vitamin supplements are used more commonly in normal healthy subjects than in patients with vitamin deficiency. Thiamine (vitamin B,) is the vitamin that most frequently induces allergic reactions. To the best of our knowledge, no case of anaphylaxis to riboflavin (vitamin B2) has thus far been reported in the literature. OBJECTIVE: We describe a previously healthy 15-year-old boy in whom anaphylaxis developed several times after he drank one soft drink or took a single multivitamin tablet. This study was done to determine which of the many components found in the soft drink and vitamin tablet caused the anaphylactic reaction. METHODS: In an outpatient clinic with the availability of complete resuscitative procedures, we performed single-blind prick skin tests and intradermal skin tests on the patient with various pure vitamin components of the soft drink and the multivitamin tablet. Physiologic saline and histamine were used for negative and positive controls, respectively. RESULTS: Riboflavin, a component of both the soft drink and the vitamin tablet, produced positive reactions on intradermal skin tests in the patient. Positive reactions were not present in the normal control subjects. CONCLUSIONS: Riboflavin is a previously unreported cause of anaphylaxis. Free-form riboflavin may potentially be associated with an anaphylactic reaction. It is a vitamin widely used in many patients with chronic disease and in healthy subjects. Vitamin B2 must be considered as a cause of anaphylaxis. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/11730188/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)62927-4 DB - PRIME DP - Unbound Medicine ER -