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Clinical effects of sulphite additives.

Abstract

Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Topical, oral or parenteral exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however, exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. While contact sensitivity to sulphite additives in topical medications is increasingly being recognized, skin reactions also occur after ingestion of or parenteral exposure to sulphites. Most studies report a 3-10% prevalence of sulphite sensitivity among asthmatic subjects following ingestion of these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. In addition to episodic and acute symptoms, sulphites may also contribute to chronic skin and respiratory symptoms. To date, the mechanisms underlying sulphite sensitivity remain unclear, although a number of potential mechanisms have been proposed. Physicians should be aware of the range of clinical manifestations of sulphite sensitivity, as well as the potential sources of exposure. Minor modifications to diet or behaviour lead to excellent clinical outcomes for sulphite-sensitive individuals.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    National Centre for Epidemiology and Population Health, ANU College of Medicine and Health Sciences, The Australian National University, Canberra ACT 0200, Australia. Hassan.Vally@anu.edu.au

    ,

    Source

    MeSH

    Animals
    Asthma
    Drug Industry
    Food Industry
    Food Preservatives
    Humans
    Sulfites

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19775253

    Citation

    Vally, H, et al. "Clinical Effects of Sulphite Additives." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 39, no. 11, 2009, pp. 1643-51.
    Vally H, Misso NL, Madan V. Clinical effects of sulphite additives. Clin Exp Allergy. 2009;39(11):1643-51.
    Vally, H., Misso, N. L., & Madan, V. (2009). Clinical effects of sulphite additives. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 39(11), pp. 1643-51. doi:10.1111/j.1365-2222.2009.03362.x.
    Vally H, Misso NL, Madan V. Clinical Effects of Sulphite Additives. Clin Exp Allergy. 2009;39(11):1643-51. PubMed PMID: 19775253.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical effects of sulphite additives. AU - Vally,H, AU - Misso,N L A, AU - Madan,V, Y1 - 2009/09/22/ PY - 2009/9/25/entrez PY - 2009/9/25/pubmed PY - 2009/12/16/medline SP - 1643 EP - 51 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 39 IS - 11 N2 - Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Topical, oral or parenteral exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however, exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. While contact sensitivity to sulphite additives in topical medications is increasingly being recognized, skin reactions also occur after ingestion of or parenteral exposure to sulphites. Most studies report a 3-10% prevalence of sulphite sensitivity among asthmatic subjects following ingestion of these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. In addition to episodic and acute symptoms, sulphites may also contribute to chronic skin and respiratory symptoms. To date, the mechanisms underlying sulphite sensitivity remain unclear, although a number of potential mechanisms have been proposed. Physicians should be aware of the range of clinical manifestations of sulphite sensitivity, as well as the potential sources of exposure. Minor modifications to diet or behaviour lead to excellent clinical outcomes for sulphite-sensitive individuals. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/19775253/full_citation L2 - https://doi.org/10.1111/j.1365-2222.2009.03362.x DB - PRIME DP - Unbound Medicine ER -