Pre-lethal anaphylaxis to carboxymethylcellulose confirmed by identification of specific IgE--review of the literature
Dumond, P.; Franck, P.; Morisset, M.; Sainte Laudy, J.; Kanny, G.; Moneret-Vautrin, D.A.
European Annals of Allergy and Clinical Immunology 41(6): 171-176
2009
ISSN/ISBN: 1764-1489 PMID: 20128230 Document Number: 14165
Carboxymethylcellulose (CMC) is used extensively in the pharmaceutical and food industries on account of its various properties. Anaphylactic reactions are rare. It has been reported principally after intra-articular infiltration of sustained-release corticosteroids containing CMC and, very rarely, after barium enema. A case of pre-lethal anaphylactic shock after barium enema was studied by prick-test, intra-dermal reaction (IDR), leukocyte histamine release test (LHRT), basophil activation test (BAT), cystein-leukotriene release test (CAST) and dot-blot analysis. IDR to CMC was positive at a concentration of 10 microg/ml. BAT and CAST were positive. Specific IgE were identified using dot-blot analysis. This is the third report of CMC-specific IgE and the second of anaphylaxis to CMC associated with a barium suspension in contact with GI tract mucosa. CMC as an excipient in medicinal products may therefore be a risk factor for severe anaphylaxis after injection or following contact with GI tract mucosa. Sensitization and allergic reactions by CMC in food additives have to be considered.
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