Dextran allergy

In efforts to elucidate whether this test can be used as a diagnostic method for dextran allergy, lymphocytes of 19 dextran reactors and 30 normal subjects were studied. No mitogenic effect of dextran 60 (Macrodex) or dextran 40 (Rheomacrodex) at concentrations between 2 x 10 " and 3 x 10 Af was, however, demonstrable (Ring 1978 b). Negative results in the lymphocyte transformation test were also obtained in three patients with dextran reactions, studied by Kohen et al. (1970). 

H, Devey ME Immunoglobulin class and subclass distribution of dextran-reactive antibodies in human reactors and non-reactors to clinical dex-tran. Allergy 1982 37 481-489. 

West, G.B. 1982. Rectal absorption of dextran in rats in the presence of salicylates. Int Arch Allergy Appl Immunol 68 283. 

Owing to the risk of a hypersensitivity reaction, a small test dose of iron dextran should always be given before full intramuscular or intravenous doses are given. Patients with a strong history of allergy and patients who have previously received parenteral iron are more likely to have hypersensitivity reactions following treatment with parenteral iron dextran. 

Multivariate analysis showed four independent susceptibility factors the administration of gelatins (OR = 4.81), the administration of dextrans (OR = 3.83), a history of drug allergy (OR = 3.16), and being male (OR = 1.98). 

Hernandez D, de Rojas F, Martinez Escribano C, Arriaga F, Cuellar J, MoUns J, Barber L. Fatal dextran-induced allergic anaphylaxis. Allergy 2002 57(9) 862. 

Allergy to icodextrin was the most likely explanation for the severe cutaneous reaction. The epitope(s) for allergic reactions to dextrans have not been defined, although they are undoubtedly immunogenic. It is possible that the same or a similar epitope may be responsible for allergic reactions to icodextrin. 

Patients with a history of allergy may be at risk of developing undesrred immunological reactions, for example attacks of asthma, after parenteral iron dextran however. 

Coutinho A, Moeller G, Richter W (1974) Molecular basis of B cell activation. I. Mitogenic-ity of native and substitutes dextrans. Scand J Immunol 3 321 De Week AL (1975) Molecular mechanisms of T and B lymphocyte triggering. Int Arch Allergy Appl Immunol 49 247... 

Reske-Nielsen E, Bojsen-Moller M, Vetner M, Hansen JC (1976) Polyvinylpyrrolidone-storage disease. Acta Pathol Microbiol Scand [A] 84 397-405 Richter AW (1974) Cross-reactivity of synthetic linear dextran with anti-B 512 dextran. Int Arch Allergy Appl Immunol 46 438-447... 

T.M.Harris, Rats Resistant to Dextran and Egg-white, Int. Archs Allergy appl. Immun. 22, 109-111 (1963). 

H. Selye, Influence of Inoculation Site upon the Course of the Anaphylactoid Reaction to Dextran, J. Allergy 25, 97-103 (1954). 

H. Selye and A. Somogyi, Various Connective-Tissue Reactions as Influenced by Dextrans of Different Molecular Weight, Ann. Allergy 26, 1-9 (1968). 

Zanoni G, Puccetti A, Dolcino M, Simone R, Peretti A, Ferro A, Tridente G. Dextran-specific IgG response in hypersensitivity reactions to measles-mumps-rubella vaccine. J Allergy Clin Immunol 2008 122(6) 1233-5. 

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