Allergy to ACTH

The diagnosis is not difficult. The one problem is not to forget to ask the patient have you experienced any incident after your previous injections of Synacthen It is often more difficult, as we have just stated, to appreciate the nature of the accident direct histamine release or type I allergy Skin tests, if properly used, give very interesting information. If they are positive with 1 100 or 1 1,000 dilutions, they confirm that the patient is sensitive to J -l,24-corticotrophin (Fig. 3) but this can be due either to allergy or to histamine release by the mast cells of the skin. 

To know if there is really an antigen-antibody reaction it is necessary to use other methods. A Prausnitz-Kiistner reaction was used with success in one of the cases related by Patriarca et al. (1974). In our cases, we have never succeeded in 

There is no special treatment. Antihistamines and corticosteroids are very efficent and epinephrine is advisable in the rare cases of acute shock with or without edema of the larynx. After the accident, it is usually possible to treat the patient without the help of corticotrophin. However, in some cases, this treatment may appear necessary and in these cases desensitization has been attempted [with success in two cases of multiple sclerosis observed by Patriarca et al. (1974)]. 

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Brodewall EK (1954) Allergic reactions due to corticotrophin. North Am Med 51 303 Brown EM, Hollander JL (1951) Allergy to ACTH and the use of beef ACTH. In Proceedings, II clinical ACTH conference. Blakiston Division, McGraw-Hill, New York Philadelphia, p 391... 

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